食管闭锁-气管食管瘘对多胎妊娠结局的影响。
Outcomes of multi-gestational pregnancies affected by esophageal atresia - tracheoesophageal fistula.
机构信息
Division of General and Thoracic Surgery, The Hospital for Sick Children, Department of Surgery, University of Toronto, Toronto, Ontario, Canada; Division of Gastroenterology, Hepatology and Nutrition, The Hospital for Sick Children, Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada.
Division of General and Thoracic Surgery, The Hospital for Sick Children, Department of Surgery, University of Toronto, Toronto, Ontario, Canada.
出版信息
J Pediatr Surg. 2019 Oct;54(10):2080-2083. doi: 10.1016/j.jpedsurg.2019.04.026. Epub 2019 May 6.
BACKGROUND
Contemporary outcomes of infants with esophageal atresia with or without tracheoesophageal fistula (EA/TEF) from multi-gestational pregnancies compared to those of singleton pregnancies have not been reported.
METHODS
A single-center retrospective review of EA/TEF patients born from 1999 to 2013 was performed. Patient demographics, gestational age (GA), birth weight, associated anomalies, requirement for gastrostomy tube and mortality were reviewed.
RESULTS
Singleton EA/TEF patients outnumbered those from multi-gestational pregnancies nearly 10:1 (214 vs 22 patients). EA/TEF patients from multi-gestational pregnancies were more likely to be premature (77% vs. 32%), have lower birth weight (mean 1766 g vs. 2695 g), have associated duodenal atresia (18% vs. 6%) and require gastrostomy tube (41% vs. 33%) for feeding challenges compared to EA/TEF singletons. Mortality was also significantly greater for multi-gestational EA/TEF patients compared to singleton EA/TEF patients (18% vs. 6%).
CONCLUSION
EA/TEF infants from multi-gestational pregnancies have greater clinical complexity and mortality than singleton EA/TEF patients. Parents of EA/TEF multi-gestational infants should be appropriately counseled and supported.
背景
多胎妊娠中合并食管闭锁（EA）和/或食管气管瘘（TEF）的婴儿与单胎妊娠的婴儿相比，其近期预后情况尚未有相关报道。
方法
对 1999 年至 2013 年间出生的 EA/TEF 患儿进行了单中心回顾性研究。对患儿的人口统计学资料、胎龄（GA）、出生体重、相关畸形、是否需要胃造口管以及死亡率进行了评估。
结果
多胎妊娠中 EA/TEF 患儿的数量明显少于单胎妊娠（214 例比 22 例）。多胎妊娠的 EA/TEF 患儿多为早产儿（77%比 32%），出生体重较低（平均 1766 克比 2695 克），存在十二指肠闭锁（18%比 6%），且需要胃造口管进行喂养（41%比 33%）的比例较高。多胎妊娠 EA/TEF 患儿的死亡率也明显高于单胎妊娠 EA/TEF 患儿（18%比 6%）。
结论
与单胎 EA/TEF 患儿相比，多胎妊娠的 EA/TEF 患儿具有更高的临床复杂性和死亡率。多胎妊娠 EA/TEF 患儿的父母应得到适当的咨询和支持。
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