Short and medium term outcomes of omphalocele and gastroschisis: a survey of a tertiary center

Abstract

Objective: To characterize and compare the outcomes of omphalocele and gastroschisis from birth to 2-year of follow-up in a recent cohort at a tertiary center. Methods: This is a retrospective clinical record review of all patients with gastroschisis and omphalocele, admitted to the Neonatal Intensive Care Unit between January 2009 and December 2019. Results: There were 38 patients: 13 with omphalocele and 25 with gastroschisis. Associated anomalies were present in 6 patients (46.2%) with omphalocele and in 10 (41.7%) with gastroschisis. Compared to patients with omphalocele, those with gastroschisis had younger mothers (24.7 vs. 29.6 years; p = 0.033), were born earlier (36 vs. 37 weeks, p = 0.006), with smaller birth weight (2365  430.4 vs. 2944.2  571.9 g; p = 0.001) and had a longer hospital stay (24 vs. 9 days, p = 0.001). The neonatal survival rate was 92.3% for omphalocele and 91.7% for gastroschisis. Thirty-four patients were followed-up over a median of 24 months: 13 with gastroschisis (59.1%) and 8 with omphalocele (66.7%) had at least one adverse event, mainly umbilical hernia (27.3% vs 41.7%), intestinal obstruction (31.8% vs 8.3%) and additional surgical interventions (27.3% vs 33.3%). Conclusion: Despite the high proportion of prematurity, low birth weight and protracted recovery, gastroschisis as well as omphalocele (without chromosomal abnormalities) may achieve very high survival rates; on the other hand, complications may develop in the first years of life. Thus, a very positive perspective in terms of survival should be transmitted to future parents, but they should also be informed that substantial morbidity may occur in medium-term.