Department of Pediatrics, Division of Neonatology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Pediatr Neonatol. 2011 Aug;52(4):219-22. doi: 10.1016/j.pedneo.2011.05.012. Epub 2011 Jun 11.
Gastroschisis (GS) is defined as a full-thickness paraumbilical abdominal wall defect associated with evisceration of fetal abdominal organ. Although the concomitant nongastrointestinal anomalies and aneuploidy are rarely presented, fetal growth restriction is common. The aim of this study is to compare the primary and secondary outcomes of GS between infants small for gestational age (SGA) and those appropriate for gestational age as well as term and late preterm infants.
Chart records of neonates born with gestational age at or more than 34 weeks were reviewed. All babies received repair procedure immediately after birth. SGA was defined as birth weight for gestational age below the 10th percentile. The primary outcomes were the length of hospital stay, duration of total parental nutrition used, and the surgical complications. The secondary outcome was the percentile of body weight at 6 months old.
There were 21 babies diagnosed with GS from January 1990 to January 2010 at Kaohsiung Chang Gung Memorial Hospital. Four (19%) babies expired soon after operation. Nine (53%) of the 17 surviving babies had SGA. Length of hospital stay, surgical complications, and the percentile of body weight at 6 months old were significantly poorer for the SGA compared with appropriate for gestational age group (p = 0.005, 0.050, and 0.035). Furthermore, preterm neonates in SGA group had lower Apgar scores at 1 minute and 5 minutes than did term neonates (p = 0.045 and 0.031).
SGA commonly occurred in GS cases and it was associated with longer hospital stay, more operative complications, and less body weight gain. Our conclusion may provide informative data to parents of GS fetuses during prenatal consultation, and reminds us that long-term follow-up of these cases could be necessary.
先天性腹裂（GS）定义为全层脐旁腹壁缺损，伴有胎儿腹部器官脱出。尽管同时存在非胃肠道畸形和非整倍体很少见，但胎儿生长受限很常见。本研究旨在比较小于胎龄儿（SGA）和适于胎龄儿以及足月和晚期早产儿 GS 的主要和次要结局。
回顾了在 34 周或以上胎龄出生的新生儿的图表记录。所有婴儿均在出生后立即接受修复手术。SGA 定义为出生体重低于第 10 百分位数的胎龄。主要结局是住院时间、总肠外营养使用时间和手术并发症。次要结局是 6 个月时体重的百分位数。
1990 年 1 月至 2010 年 1 月，高雄长庚纪念医院共诊断出 21 例 GS 患儿。4 例（19%）患儿在手术后不久死亡。17 例存活患儿中，9 例（53%）为 SGA。与适于胎龄组相比，SGA 组的住院时间、手术并发症和 6 个月时体重的百分位数明显较差（p = 0.005、0.050 和 0.035）。此外，SGA 组早产儿在 1 分钟和 5 分钟时的 Apgar 评分均低于足月儿（p = 0.045 和 0.031）。
SGA 在 GS 病例中很常见，与住院时间延长、手术并发症增多、体重增加减少有关。我们的结论可以为 GS 胎儿的父母提供产前咨询的信息数据，并提醒我们，这些病例可能需要长期随访。
