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Article Dans Une Revue Journal of Maternal-Fetal & Neonatal Medicine Année : 2017

Management and outcome challenges in newborns with gastroschisis: A 6-year retrospective French study

Résumé

OBJECTIVE: To identify the gestational age (GA) at which risk of mortality and severe outcome was minimized comparing preterm delivery and expectant management. METHODS: Retrospective study performed between 2009 and 2014 of newborns with gastroschisis in three large French level III neonatal intensive care units. Each department followed two distinct strategies: elective delivery at 35 weeks' GA and a delayed approach. RESULTS: We included 69 gastroschisis cases. The lengths of stay lasting more than 60 days were significantly greater in the planned delivery group than in the expectant approach group (18/30 (60%) vs. 8/39 (20.5%), p = 0.001). Gastroschisis cases receiving antenatal corticoids during the last two weeks of gestation required significantly less surgeries during their initial stay (p = 0.003) as well as shorter parenteral feedings (p = 0.002). A multivariate logistic regression showed that a GA of less than 36 weeks' GA was is a pejorative factor for a stay above 60 days, regardless of whether it was a simple or complex gastroschisis, (OR= 3.8; p = 0.021). A complex gastroschisis was a risk factor for significantly longer parenteral feedings, regardless of the center where patient is treated (Beta = -0.3, p = 0.035). CONCLUSIONS: Future research should focus on decisions about delivery timing by incorporating risk of neonatal morbidity.
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Dates et versions

hal-03828895 , version 1 (25-10-2022)

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Barthélémy Tosello, Meriem Zahed, Floriane Guimond, Karine Baumstarck, Alice Faure, et al.. Management and outcome challenges in newborns with gastroschisis: A 6-year retrospective French study. Journal of Maternal-Fetal & Neonatal Medicine, 2017, 30 (23), pp.2864--2870. ⟨10.1080/14767058.2016.1265935⟩. ⟨hal-03828895⟩
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