Esteche Cinthia Maria Gomes da Costa Escoto, Araujo Júnior Edward, Esteche Beatriz da Costa Escoto, Rodrigues Larissa de Oliveira Bernardo, Carvalho Francisco Herlânio Costa, Rolo Lilliam Cristine
Universidade Federal de São Paulo, Escola Paulista de Medicina, Department of Obstetrics - São Paulo (SP), Brazil.
Centro Universitário Christus, Medical School - Fortaleza (CE), Brazil.
Rev Assoc Med Bras (1992). 2025 Aug 8;71(7):e20241999. doi: 10.1590/1806-9282.20241999. eCollection 2025.
The objective of this study was to assess the risk factors for neonatal death in newborns with gastroschisis.
Hospital-based secondary analysis of a retrospective cohort study was performed in a single reference center between January 2014 and December 2023. The following variables were evaluated: maternal characteristics, obstetric aspects, habits, and labor and delivery data. Information on neonatal and hospitalization was also included.
A total of 48 newborns with gastroschisis were delivered, with 27 (56%) being discharged from the hospital, 5 (10%) being transferred to another hospital, and 16 (33%) dying. Maternal origin was associated with neonatal death, with a 4.2 times greater chance of death if the pregnant women came from the interior. Newborns who died started prenatal care significantly earlier than the survivors. Newborns with complex gastroschisis had a 4.05 times higher risk of death, while the lack of primary closure in the first approach increased this risk by a factor of 7.0. Duration of parenteral nutrition, admission to the neonatal intensive care unit, and total hospital stay were significantly shorter in the cases of death, indicating that longer periods were associated with a 5, 6, and 6% reduction in the risk of death, respectively. On the other hand, not wearing the oxygen hood helmet increased the risk of death by 6.94 times. Newborns who spent more days on mechanical ventilation were 9% more likely to die.
In conclusion, the only significant variable was the longer time on mechanical ventilation, which was associated with mortality in newborns with gastroschisis.
本研究的目的是评估腹裂新生儿的死亡风险因素。
于2014年1月至2023年12月在单一参考中心对一项回顾性队列研究进行基于医院的二次分析。评估了以下变量：母亲特征、产科情况、习惯以及分娩数据。还纳入了新生儿和住院相关信息。
共分娩48例腹裂新生儿，其中27例（56%）出院，5例（10%）转至其他医院，16例（33%）死亡。母亲籍贯与新生儿死亡有关，如果孕妇来自内地，死亡几率高4.2倍。死亡的新生儿开始产前检查的时间明显早于存活者。复杂型腹裂新生儿的死亡风险高4.05倍，而初次手术时未进行一期缝合使该风险增加7.0倍。死亡病例的肠外营养持续时间、入住新生儿重症监护病房时间和总住院时间明显更短，表明时间延长分别使死亡风险降低5%、6%和6%。另一方面，未佩戴氧气头罩头盔使死亡风险增加6.94倍。机械通气天数更多的新生儿死亡可能性高9%。
总之，唯一显著的变量是机械通气时间延长，这与腹裂新生儿的死亡率相关。
