腹裂和脐膨出婴儿的异常频率及医院结局
Frequency of anomalies and hospital outcomes in infants with gastroschisis and omphalocele.
作者信息
Corey Kristin M, Hornik Christoph P, Laughon Matthew M, McHutchison Kerstin, Clark Reese H, Smith P Brian
机构信息
Duke Clinical Research Institute, Durham, NC, USA.
Duke Clinical Research Institute, Durham, NC, USA; Department of Pediatrics, Duke University, Durham, NC, USA.
出版信息
Early Hum Dev. 2014 Aug;90(8):421-4. doi: 10.1016/j.earlhumdev.2014.05.006. Epub 2014 Jun 11.
BACKGROUND
Gastroschisis and omphalocele are the most common anterior abdominal wall defects affecting infants. There are few large cohort studies describing the frequency of associated anomalies in infants with these 2 conditions. We describe associated anomalies and outcomes in infants with these defects using a large, multi-center clinical database.
METHODS
We identified all infants with gastroschisis or omphalocele from a prospectively collected database of infants discharged from 348 neonatal intensive care units in North America from 1997 to 2012. Maternal and patient demographic data, associated anomalies, and outcome data were compared between infants with gastroschisis and omphalocele.
RESULTS
A total of 4687 infants with gastroschisis and 1448 infants with omphalocele were identified. Infants with omphalocele were more likely to be diagnosed with at least 1 other anomaly compared with infants with gastroschisis (35% vs. 8%, p<0.001). Infants with omphalocele were more likely to develop pulmonary hypertension compared with those with gastroschisis (odds ratio [OR] 7.78; 95% confidence interval 5.81, 10.41) and had higher overall mortality (OR 6.81 [5.33, 8.71]).
CONCLUSION
Infants with omphalocele were more likely to have other anomalies, be diagnosed with pulmonary hypertension, and have higher mortality than infants with gastroschisis.
背景
腹裂和脐膨出是影响婴儿的最常见的前腹壁缺陷。很少有大型队列研究描述这两种情况的婴儿中相关异常的发生率。我们使用一个大型多中心临床数据库来描述这些缺陷婴儿的相关异常和结局。
方法
我们从1997年至2012年北美348个新生儿重症监护病房出院婴儿的前瞻性收集数据库中识别出所有患有腹裂或脐膨出的婴儿。比较了腹裂和脐膨出婴儿的母亲和患者人口统计学数据、相关异常和结局数据。
结果
共识别出4687例腹裂婴儿和1448例脐膨出婴儿。与腹裂婴儿相比，脐膨出婴儿更有可能被诊断出至少一种其他异常（35%对8%，p<0.001）。与腹裂婴儿相比，脐膨出婴儿更有可能发生肺动脉高压（优势比[OR]7.78；95%置信区间5.81，10.41），且总体死亡率更高（OR 6.81[5.33，8.71]）。
结论
与腹裂婴儿相比，脐膨出婴儿更有可能有其他异常、被诊断出肺动脉高压且死亡率更高。
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