Abstract
Objective Gastroschisis is the most common congenital abdominal wall defect, with an increasing
incidence. It results in extrusion of abdominal contents with associated delayed intestinal
motility. Abnormal heart rate characteristics (HRCs) such as decreased variability
occur due to the inflammatory response to sepsis in preterm infants. This study aimed
to test the hypothesis that infants with gastroschisis have decreased heart rate variability
(HRV) after birth and that this physiomarker may predict outcomes.
Study Design We analyzed heart rate data from and clinical variables for all infants admitted
with gastroschisis from 2009 to 2020.
Results Forty-seven infants were admitted during the study period and had available data.
Complex gastroschisis infants had reduced HRV after birth. For those with sepsis and
necrotizing enterocolitis, abnormal HRCs occurred early in the course of illness.
Conclusion Decreased HRV was associated with complex gastroschisis. Infants in this group experienced
complications that prolonged time to full enteral feeding and time on total parenteral
nutrition.
Key Points
-
Infants with gastroschisis can be classified into two subcategories, simple and complex
disease.
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Those with complex disease often require prolonged stays in the neonatal intensive
care unit and costly hospitalizations. We hypothesized that infants with complex gastroschisis
are more likely to have abnormal HRC due to intestinal inflammation.
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In this study, we identified associations between abnormal HRV, heart rate characteristicHRC,
and the development of gastroschisis complications. Additionally, we described differences
in clinical characteristics between infants with complex versus simple gastroschisis.
Keywords
abdominal defect - congenital anomaly - heart rate characteristics - heart rate variability
- gastroschisis
