Am J Perinatol 2020; 37(14): 1438-1445
DOI: 10.1055/s-0039-1693988
Original Article

Factors that Influence Longitudinal Growth from Birth to 18 Months of Age in Infants with Gastroschisis

Nitya Nair
1   Division of Neonatology, Perinatal and Pulmonary Biology, Perinatal Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
,
Stephanie Merhar
1   Division of Neonatology, Perinatal and Pulmonary Biology, Perinatal Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
2   Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio
,
Jacqueline Wessel
3   Division of Nutrition Therapy, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
,
1   Division of Neonatology, Perinatal and Pulmonary Biology, Perinatal Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
2   Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio
,
1   Division of Neonatology, Perinatal and Pulmonary Biology, Perinatal Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
2   Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio
4   Cincinnati Fetal Center, Division of Pediatric General Thoracic and Fetal Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
› Author Affiliations
Funding This work was supported by a grant from the Gerber Foundation.

Abstract

Objective This study aimed to investigate factors that influence growth in infants with gastroschisis.

Study Design Growth parameters at birth, discharge, 6, 12, and 18 months of age were collected from 42 infants with gastroschisis.

Results The mean z-scores for weight, length, and head circumference were below normal at birth and decreased between birth and discharge. Lower gestational age correlated with a worsening change in weight z-score from birth to discharge (rho 0.38, p = 0.01), but not with the change in weight z-score from discharge to 18 months (rho 0.04, p = 0.81). There was no correlation between the day of life when the enteral feeds were started and the change in weight z-score from birth to discharge (rho 0.12, p = 0.44) or discharge to 18 months (rho −0.15, p = 0.41).

Conclusion Our study demonstrates that infants with gastroschisis experience a significant decline in weight z-score between birth and discharge, and start to catch up on all growth parameters after discharge. Prematurity in gastroschisis infants is associated with a greater risk for weight loss during this time. This information emphasizes the importance of minimizing weight loss prior to discharge in premature infants with gastroschisis and highlights the need for optimal management strategies for these infants.



Publication History

Received: 13 February 2019

Accepted: 24 June 2019

Article published online:
31 July 2019

© 2020. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 
  • References

  • 1 South AP, Marshall DD, Bose CL, Laughon MM. Growth and neurodevelopment at 16 to 24 months of age for infants born with gastroschisis. J Perinatol 2008; 28 (10) 702-706
  • 2 Laughon M, Meyer R, Bose C. et al. Rising birth prevalence of gastroschisis. J Perinatol 2003; 23 (04) 291-293
  • 3 Castilla EE, Mastroiacovo P, Orioli IM. Gastroschisis: international epidemiology and public health perspectives. Am J Med Genet C Semin Med Genet 2008; 148C (03) 162-179
  • 4 Arnold MA, Chang DC, Nabaweesi R. et al. Development and validation of a risk stratification index to predict death in gastroschisis. J Pediatr Surg 2007; 42 (06) 950-955
  • 5 Carnaghan H, Pereira S, James CP. et al. Is early delivery beneficial in gastroschisis?. J Pediatr Surg 2014; 49 (06) 928-933
  • 6 Carnaghan H, Baud D, Lapidus-Krol E. et al. Effect of gestational age at birth on neonatal outcomes in gastroschisis. J Pediatr Surg 2016; 51 (05) 734-738
  • 7 Soares H, Silva A, Rocha G, Pissarra S, Correia-Pinto J, Guimarães H. Gastroschisis: preterm or term delivery?. Clinics (São Paulo) 2010; 65 (02) 139-142
  • 8 Overcash RT, DeUgarte DA, Stephenson ML. et al; University of California Fetal Consortium. Factors associated with gastroschisis outcomes. Obstet Gynecol 2014; 124 (03) 551-557
  • 9 Cain MA, Salemi JL, Paul Tanner J. et al. Perinatal outcomes and hospital costs in gastroschisis based on gestational age at delivery. Obstet Gynecol 2014; 124 (03) 543-550
  • 10 Ergün O, Barksdale E, Ergün FS. et al. The timing of delivery of infants with gastroschisis influences outcome. J Pediatr Surg 2005; 40 (02) 424-428
  • 11 Mills JA, Lin Y, Macnab YC, Skarsgard ED. ; Canadian Pediatric Surgery Network. Perinatal predictors of outcome in gastroschisis. J Perinatol 2010; 30 (12) 809-813
  • 12 Nasr A, Wayne C, Bass J, Ryan G, Langer JC. ; Canadian Pediatric Surgery Network. Effect of delivery approach on outcomes in fetuses with gastroschisis. J Pediatr Surg 2013; 48 (11) 2251-2255
  • 13 Charlesworth P, Njere I, Allotey J. et al. Postnatal outcome in gastroschisis: effect of birth weight and gestational age. J Pediatr Surg 2007; 42 (05) 815-818
  • 14 Girsen AI, Do S, Davis AS. et al. Peripartum and neonatal outcomes of small-for-gestational-age infants with gastroschisis. Prenat Diagn 2015; 35 (05) 477-482
  • 15 Sharma P, McKay K, Rosenkrantz TS, Hussain N. Comparisons of mortality and pre-discharge respiratory outcomes in small-for-gestational-age and appropriate-for-gestational-age premature infants. BMC Pediatr 2004; 4: 9
  • 16 Baud D, Lausman A, Alfaraj MA. et al. Expectant management compared with elective delivery at 37 weeks for gastroschisis. Obstet Gynecol 2013; 121 (05) 990-998
  • 17 Serra A, Fitze G, Kamin G, Dinger J, König IR, 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 (01) 32-37
  • 18 Gelas T, Gorduza D, Devonec S. et al. Scheduled preterm delivery for gastroschisis improves postoperative outcome. Pediatr Surg Int 2008; 24 (09) 1023-1029
  • 19 Harper LM, Goetzinger KR, Biggio JR, Macones GA. Timing of elective delivery in gastroschisis: a decision and cost-effectiveness analysis. Ultrasound Obstet Gynecol 2015; 46 (02) 227-232
  • 20 Huang J, Kurkchubasche AG, Carr SR, Wesselhoeft Jr CW, Tracy Jr TF, Luks FL. Benefits of term delivery in infants with antenatally diagnosed gastroschisis. Obstet Gynecol 2002; 100 (04) 695-699
  • 21 Gupta R, Cabacungan ET. Outcome of neonates with gastroschisis at different gestational ages using a national database. J Pediatr Surg 2018; 53 (04) 661-665
  • 22 Logghe HL, Mason GC, Thornton JG, Stringer MD. A randomized controlled trial of elective preterm delivery of fetuses with gastroschisis. J Pediatr Surg 2005; 40 (11) 1726-1731
  • 23 Grant NH, Dorling J, Thornton JG. Elective preterm birth for fetal gastroschisis. Cochrane Database Syst Rev 2013; (06) CD009394
  • 24 Al-Kaff A, MacDonald SC, Kent N, Burrows J, Skarsgard ED, Hutcheon JA. ; Canadian Pediatric Surgery Network. Delivery planning for pregnancies with gastroschisis: findings from a prospective national registry. Am J Obstet Gynecol 2015; 213 (04) 557.e1-557.e8
  • 25 Netta DA, Wilson RD, Visintainer P. et al. Gastroschisis: growth patterns and a proposed prenatal surveillance protocol. Fetal Diagn Ther 2007; 22 (05) 352-357
  • 26 Hong CR, Zurakowski D, Fullerton BS, Ariagno K, Jaksic T, Mehta NM. Nutrition delivery and growth outcomes in infants with gastroschisis. J Parenter Enteral Nutr 2018; 42 (05) 913-919
  • 27 Minutillo C, Rao SC, Pirie S, McMichael J, Dickinson JE. Growth and developmental outcomes of infants with gastroschisis at one year of age: a retrospective study. J Pediatr Surg 2013; 48 (08) 1688-1696
  • 28 Payne NR, Simonton SC, Olsen S, Arnesen MA, Pfleghaar KM. Growth restriction in gastroschisis: quantification of its severity and exploration of a placental cause. BMC Pediatr 2011; 11: 90
  • 29 Balgi S, Singhal S, Mueller G, Batton B. Feeding intolerance and poor growth in infants with gastroschisis: longitudinal experience with consecutive patients over thirteen years. J Neonatal Surg 2015; 4 (04) 42
  • 30 Fullerton BS, Velazco CS, Sparks EA. et al. Contemporary outcomes of infants with gastroschisis in North America: a multicenter cohort study. J Pediatr 2017; 188: 192-197
  • 31 Chen IL, Lee SY, Ou-Yang MC. et al. Clinical presentation of children with gastroschisis and small for gestational age. Pediatr Neonatol 2011; 52 (04) 219-222
  • 32 Fenton TR, Kim JH. A systematic review and meta-analysis to revise the Fenton growth chart for preterm infants. BMC Pediatr 2013; 13: 59
  • 33 Gortner L, van Husen M, Thyen U, Gembruch U, Friedrich HJ, Landmann E. Outcome in preterm small for gestational age infants compared to appropriate for gestational age preterms at the age of 2 years: a prospective study. Eur J Obstet Gynecol Reprod Biol 2003; 110 (Suppl. 01) S93-S97
  • 34 Hediger ML, Overpeck MD, McGlynn A, Kuczmarski RJ, Maurer KR, Davis WW. Growth and fatness at three to six years of age of children born small- or large-for-gestational age. Pediatrics 1999; 104 (03) e33
  • 35 Walter-Nicolet E, Rousseau V, Kieffer F. et al. Neonatal outcome of gastroschisis is mainly influenced by nutritional management. J Pediatr Gastroenterol Nutr 2009; 48 (05) 612-617
  • 36 Bryant M, Santorelli G, Fairley L. et al; Born in Bradford Childhood Obesity Scientific Group. Agreement between routine and research measurement of infant height and weight. Arch Dis Child 2015; 100 (01) 24-29