Background: Gastroschisis is a congenital defect of the abdominal wall requiring emergency surgical intervention, leading to complications which could affect the outcomes of neonates. Objective: To provide maternal and neonatal characteristics, complications, short-term and long-term outcomes of neonates with gastroschisis in Northeastern Thailand. Design/Methods: A retrospective study of neonates with gastroschisis treated at two of the largest tertiary centers in the region from January 2012 to December 2021 was performed. Medical records during hospitalization and post-discharge visits up to 18 months were reviewed. Results: There were 163 neonates with gastroschisis and 24 (14.7%) had bowel anomalies which intestinal atresia was the most common. Mean gestational age was 36.0 ± 1.9 weeks and mean birth weight was 2227 ± 481 grams. Seventy-four neonates (45.4%) were male, 104 (63.8%) were preterm and 56 (34.4%) were small for gestational age. There were 94 teenage mothers (57.7%) and 89 vaginal deliveries (54.6%). Prenatal diagnosis was made in 86 cases (52.8%). Primary closure was achieved in 92 neonates (56.4%) while silo procedure occurred in 71 neonates (43.6%). Median time to skin closure among neonates with silo procedure was 7 days (range 3-148) but 10 neonates did not have surgical closure either due to death or epithelization of skin. Median of parenteral nutrition duration was 23 days (range 0-503). Feeding was started in 158 neonates (96.9%) but only 153 (93.9%) achieved full feeding. Median age of feeding initiation was 14 days (range 3-116) with median time to full feed of 10 days after initiation (range 4-188) and median length of stays of 30 days (range 3-503). Proven sepsis occurred in 33 neonates (20.2%) and cholestasis occurred in 77 neonates (47.2%). There were 12 (7.4%) deaths; 6 cases from sepsis, 4 from liver failure, 1 from congenital anomaly, and 1 neonate died from burn injury during transfer. Neonates with bowel anomalies had higher deaths than neonates without (26.3% vs 5.3%;p=0.018). At discharge, 151 neonates (92.6%) survived which 56 (37.1%) had normal growth. At 12-month visit, 141 neonates (93.4%) were accounted and 110 (78.0%) had normal growth. Bayley Scales of Infant and Toddler Development result at 18-month was available in 82 neonates (54.3%) which 72 (87.8%) had normal development.
Conclusion(s): Neonates with gastroschisis had generally favorable outcomes with most neonates were able to achieve normal growth and development but bowel anomalies were associated with poor outcomes. Preventing complications and providing comprehensive follow up program should be emphasized.
