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Prenatal markers and longitudinal follow-up in simple and complex gastroschisis
  1. Annelieke Hijkoop1,
  2. Hanneke IJsselstijn1,
  3. René M H Wijnen1,
  4. Dick Tibboel1,
  5. Joost van Rosmalen2,
  6. Titia E Cohen-Overbeek3
  1. 1Intensive Care and Department of Paediatric Surgery, Erasmus MC – Sophia Children’s Hospital, Rotterdam, The Netherlands
  2. 2Department of Biostatistics, Erasmus MC, Rotterdam, The Netherlands
  3. 3Department of Obstetrics and Gynaecology, Division of Obstetrics and Prenatal Medicine, Erasmus MC – Sophia Children’s Hospital, Rotterdam, The Netherlands
  1. Correspondence to Dr Hanneke IJsselstijn, Intensive Care and Department of Paediatric Surgery, Erasmus MC – Sophia Children's Hospital, 3000 CB Rotterdam, The Netherlands; h.ijsselstijn{at}erasmusmc.nl

Abstract

Objective We aimed to identify gestational-age corrected prenatal ultrasound markers of complex gastroschisis, and to compare physical growth and neurodevelopment between children with simple and complex gastroschisis.

Design We included prenatally diagnosed gastroschisis patients from 2000 to 2012 who joined our longitudinal follow-up programme. Associations between complex gastroschisis and prenatal ultrasound markers collected at 30 weeks’ gestation and prior to delivery were tested using logistic regression. Physical growth (SD scores (SDS)), mental and psychomotor developmental index (MDI, PDI; Bayley Scales of Infant Development) were recorded at 12 and 24 months. Data were analysed using general linear models and compared with population norms.

Results Data of 61 children were analysed (82% of eligible cases). Extra-abdominal bowel dilatation at 30 weeks’ gestation was significantly associated with complex gastroschisis (OR (95% CI): 5.00 (1.09 to 22.98)), with a high negative (88%) but low positive (40%) predictive value. The mean (95% CI) height SDS at 12 months (−0.46 (–0.82 to –0.11)), and weight SDS at 12 and 24 months (−0.45 (–0.85 to –0.05), and −0.44 (−0.87 to –0.01), respectively) fell significantly below 0 SDS. MDI and PDI were significantly below 100 at 24 months; 93 (88 to 99) and 83 (78 to 87), respectively). Children with complex gastroschisis had a significantly lower PDI (76 (68 to 84)) than those with simple gastroschisis (94 (90 to 97), p<0.001).

Conclusions Prenatal ultrasound markers could not reliably distinguish between simple and complex gastroschisis. Children with complex gastroschisis may be at increased risk for delayed psychomotor development; they should be monitored more closely, and offered timely intervention.

  • gastroschisis
  • abdominal wall defect
  • outcome
  • follow-up
  • growth
  • neurodevelopment

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Footnotes

  • Contributors Each author has contributed to the article. Each author listed has seen and approved the final version of the manuscript and takes full responsibility for the manuscript.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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