Am J Perinatol 2011; 28(9): 689-694
DOI: 10.1055/s-0031-1280597
© Thieme Medical Publishers

Fetal Gastroschisis: Epidemiological Characteristics and Pregnancy Outcomes in Mississippi

Kiran B. Tam Tam1 , Christian Briery1 , Alan D. Penman2 , Laura Bufkin1 , James A. Bofill1
  • 1Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Jackson, Mississippi
  • 2Department of Medicine, University of Mississippi Medical Center, Jackson, Mississippi
Further Information

Publication History

Publication Date:
22 June 2011 (online)

ABSTRACT

We describe the epidemiological characteristics and identify maternal–fetal outcomes in pregnancies complicated by gastroschisis. We retrospectively reviewed 115 cases of gastroschisis at the University of Mississippi Medical Center. The incidence of gastroschisis trended upward between 2000 and 2008. Significant proportions of mothers were nonobese, nulliparous, teenagers, smokers, and nonconsumers of alcohol. Infants delivered at >36 weeks or without sepsis had shorter hospital stay (HS) and interval to full enteral feeding (FEF). The rates of low birth weight (LBW), fetal growth restriction, and spontaneous preterm birth (PTB) were 63%, 45%, and 24%, respectively. Bowel atresia was noted in 9%. Rates of primary closure (25%), neonatal sepsis (29%), fetal death (2%), and infant mortality (4%) were notable. Median HS and interval to FEF were 40 and 30 days, respectively. The incidence of gastroschisis is increasing in Mississippi. Sepsis, LBW, and PTB are key determinants of poor infant outcomes.

REFERENCES

  • 1 Canfield M A, Honein M A, Yuskiv N et al.. National estimates and race/ethnic-specific variation of selected birth defects in the United States, 1999–2001.  Birth Defects Res Part A Clin Mol Teratol. 2006;  76 747-756
  • 2 Torfs C P, Christianson R E, Iovannisci D M, Shaw G M, Lammer E J. Selected gene polymorphisms and their interaction with maternal smoking, as risk factors for gastroschisis.  Birth Defects Res A Clin Mol Teratol. 2006;  76 723-730
  • 3 Draper E S, Rankin J, Tonks A M et al.. Recreational drug use: a major risk factor for gastroschisis?.  Am J Epidemiol. 2008;  167 485-491
  • 4 James A H, Brancazio L R, Price T. Aspirin and reproductive outcomes.  Obstet Gynecol Surv. 2008;  63 49-57
  • 5 Werler M M. Teratogen update: pseudoephedrine.  Birth Defects Res A Clin Mol Teratol. 2006;  76 445-452
  • 6 Feldkamp M L, Reefhuis J, Kucik J et al.. Case-control study of self reported genitourinary infections and risk of gastroschisis: findings from the national birth defects prevention study, 1997–2003.  BMJ. 2008;  336 1420-1423
  • 7 Siega-Riz A M, Olshan A F, Werler M W, Moore C A. National Birth Defects Prevention Study. Fat intake and the risk of gastroschisis.  Birth Defects Res A Clin Mol Teratol. 2006;  76 241-245
  • 8 Waller D K, Shaw G M, Rasmussen S A National Birth Defects Prevention Study et al. Prepregnancy obesity as a risk factor for structural birth defects.  Arch Pediatr Adolesc Med. 2007;  161 745-750
  • 9 Reid K P, Dickinson J E, Doherty D A. The epidemiologic incidence of congenital gastroschisis in Western Australia.  Am J Obstet Gynecol. 2003;  189 764-768
  • 10 Penman D G, Fisher R M, Noblett H R, Soothill P W. Increase in incidence of gastroschisis in the south west of England in 1995.  Br J Obstet Gynaecol. 1998;  105 328-331
  • 11 Centers for Disease Control and Prevention (CDC) . Hospital stays, hospital charges, and in-hospital deaths among infants with selected birth defects—United States, 2003.  MMWR Morb Mortal Wkly Rep. 2007;  56 25-29
  • 12 Srivastava V, Mandhan P, Pringle K, Morreau P, Beasley S, Samarakkody U. Rising incidence of gastroschisis and exomphalos in New Zealand.  J Pediatr Surg. 2009;  44 551-555
  • 13 Bermejo E, Mendioroz J, Cuevas L, Martínez-Frías M L. The incidence of gastroschisis: is also increasing in Spain, particularly among babies of young mothers.  BMJ. 2006;  332 424
  • 14 Kilby M D. The incidence of gastroschisis.  BMJ. 2006;  332 250-251
  • 15 Sekabira J, Hadley G P. Gastroschisis: a third world perspective.  Pediatr Surg Int. 2009;  25 327-329
  • 16 Vu L T, Nobuhara K K, Laurent C, Shaw G M. Increasing prevalence of gastroschisis: population-based study in California.  J Pediatr. 2008;  152 807-811
  • 17 Zhou G X, Zhu J, Dai L, Wang Y P, Liang J, Miao L. An epidemiological investigation on gastroschisis in China during 1996 to 2000.  Zhonghua Yu Fang Yi Xue Za Zhi. 2005;  39 257-259
  • 18 Mississippi State Department of Health vital statistics annual reports 2000, 2001, 2002, 2003, 2004, 2005, 2006 and 2007. Available at: http://www.msdh.state.ms.us/msdhsite/index.cfm/31,0,75,html (accessed June 2011)
  • 19 Alexander G R, Himes J H, Kaufman R B, Mor J, Kogan M. A United States national reference for fetal growth.  Obstet Gynecol. 1996;  87 163-168
  • 20 Shepard M J, Richards V A, Berkowitz R L, Warsof S L, Hobbins J C. An evaluation of two equations for predicting fetal weight by ultrasound.  Am J Obstet Gynecol. 1982;  142 47-54
  • 21 Vu L T, Nobuhara K K, Laurent C, Shaw G M. Increasing prevalence of gastroschisis: population-based study in California.  J Pediatr. 2008;  152 807-811
  • 22 Hougland K T, Hanna A M, Meyers R, Null D. Increasing prevalence of gastroschisis in Utah.  J Pediatr Surg. 2005;  40 535-540
  • 23 Alvarez S M, Burd R S. Increasing prevalence of gastroschisis repairs in the United States: 1996–2003.  J Pediatr Surg. 2007;  42 943-946
  • 24 Centers for Disease Control and Prevention .Preconception and interconception health status of women who recently gave birth to a live-born infant—Pregnancy risk assessment monitoring system (PRAMS) in United States, 2004. 2007/56(SS10);1–35 Available at: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5731a2.htm (accessed June 2011)
  • 25 Centers for Disease Control and Prevention (CDC) . Smoking prevalence among women of reproductive age—United States, 2006.  MMWR Morb Mortal Wkly Rep. 2008;  57 849-852
  • 26 Jacobson S W, Chiodo L M, Sokol R J, Jacobson J L. Validity of maternal report of prenatal alcohol, cocaine, and smoking in relation to neurobehavioral outcome.  Pediatrics. 2002;  109 815-825
  • 27 Mac Bird T, Robbins J M, Druschel C et al.. Demographic and environmental risk factors for gastroschisis and omphalocele in the National Birth Defects Prevention Study.  J Pediatr Surg. 2009;  44 1546-1551
  • 28 Lausman A Y, Langer J C, Tai M et al.. Gastroschisis: what is the average gestational age of spontaneous delivery?.  J Pediatr Surg. 2007;  42 1816-1821
  • 29 Serra A, Fitze G, Kamin G, Dinger J, König I R, Roesner D. Preliminary report on elective preterm delivery at 34 weeks and primary abdominal closure for the management of gastroschisis.  Eur J Pediatr Surg. 2008;  18 32-37
  • 30 Salihu H M, Emusu D, Aliyu Z Y, Pierre-Louis B J, Druschel C M, Kirby R S. Mode of delivery and neonatal survival of infants with isolated gastroschisis.  Obstet Gynecol. 2004;  104 678-683
  • 31 Puligandla P S, Janvier A, Flageole H, Bouchard S, Laberge J M. Routine cesarean delivery does not improve the outcome of infants with gastroschisis.  J Pediatr Surg. 2004;  39 742-745

James A BofillM.D. 

Fellowship Program Director, Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology

University of Mississippi Medical Center, 2500 N. State Street, Jackson, MS 39216-4505

Email: jbofill@umc.edu