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Eur J Pediatr Surg 2020; 30(06): 536-540
DOI: 10.1055/s-0039-3401797
Original Article

Gastroschisis in Finland 1993 to 2014—Increasing Prevalence, High Rates of Abortion, and Survival: A Population-Based Study

Arimatias Raitio 
1   Department of Paediatric Surgery and Orthopaedics, Turku University Hospital, Turku, Finland
2   Department of Paediatric Surgery and Orthopaedics, University of Turku Faculty of Medicine, Turku, Finland
,
Asta Lahtinen
3   Department of Paediatric Surgery, Kuopio University Hospital, Kuopio, Pohjois-Savo, Finland
,
Johanna Syvänen
1   Department of Paediatric Surgery and Orthopaedics, Turku University Hospital, Turku, Finland
2   Department of Paediatric Surgery and Orthopaedics, University of Turku Faculty of Medicine, Turku, Finland
,
Teemu Kemppainen
4   Department of Biostatistics, University of Turku, Turku, Finland
5   Department of Biostatistics, Turku University Hospital, Turku, Finland
,
Eliisa Löyttyniemi
4   Department of Biostatistics, University of Turku, Turku, Finland
5   Department of Biostatistics, Turku University Hospital, Turku, Finland
,
Mika Gissler
6   Information Services Department, National Institute for Health and Welfare, Helsinki, Finland
7   Department of Neurobiology, Karolinska Institute, Stockholm, Stockholm County, Sweden
,
Anna Hyvärinen
8   Department of Paediatric Surgery, Tampere University Hospital, Tampere, Finland
9   Department of Paediatric Surgery, Tampere University Faculty of Medicine, Tampere, Finland
,
Ilkka Helenius
1   Department of Paediatric Surgery and Orthopaedics, Turku University Hospital, Turku, Finland
2   Department of Paediatric Surgery and Orthopaedics, University of Turku Faculty of Medicine, Turku, Finland
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Abstract

Introduction The study aims to assess the changes in prevalence and mortality of gastroschisis, and to identify associated anomalies.

Materials and Methods It is a population-based nationwide study. All gastroschisis cases were identified in the Finnish Register of Congenital Malformations and the Care Register for Health Care from 1993 to 2014 including live births, stillbirths, and terminations of pregnancy due to fetal anomalies. Associated anomalies were recorded, and analyzed, and prevalence and infant mortality were calculated.

Results There were 320 cases of gastroschisis; 235 (73%) live births, 16 (5%) stillbirths, and 69 (22%) terminations of pregnancy. Live birth prevalence of gastroschisis in Finland was lower than generally reported (1.73 in 10,000). However, due to relatively high rates of abortion, our total prevalence of 2.57/10,000 was similar with other reports. The most common risk factor was young maternal age. Babies with gastroschisis were born prematurely, on average on the 36th week and most are delivered by caesarean section. There was a significant increasing trend in live birth prevalence (p = 0.0018). Overall infant mortality was 7.7% (18/235), 7.2% (16/222) in simple gastroschisis and 15% (2/13) in complex gastroschisis. Associated anomalies were rare both in aborted fetuses and neonates, and there was only one case with a chromosomal abnormality.

Conclusion Gastroschisis is usually an isolated anomaly with increasing birth prevalence and excellent survival rates. Regardless of the good prognosis, the abortion rates in Finland are higher than previously reported, and we hypothesize this to be due to lack of appropriate antenatal counselling.

Keywords

gastroschisis - birth prevalence - termination of pregnancy


Publication History

Received: 28 August 2019

Accepted: 01 April 2019

Article published online:
31 December 2019

© 2020. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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