Document Detail


Mode of delivery and neonatal survival of infants with gastroschisis in Australia and New Zealand.
MedLine Citation:
PMID:  18779007     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: The aim of the study was to examine the short-term outcome of infants with gastroschisis by route of delivery, comparing vaginal delivery vs elective and emergency cesarean delivery (CD). METHODS: Six hundred thirty-one infants with gastroschisis (International Classification of Diseases, 10th Revision: Q79.3) were admitted to the Australian and New Zealand Neonatal Network during 1997 to 2005. Multivariate Cox proportional hazards regression analysis was performed to adjust for case-mix and significant baseline characteristics. RESULTS: During the study period, 631 infants with gastroschisis were admitted to the collaborating centers. Of these, 343 (54.4%) infants were delivered vaginally, whereas 288 (45.6%) were delivered by cesarean birth. Of the latter, 148 (23.4%) were elective and 140 (22.2%) were emergency. There was an increasing trend of CD from 41.1% in 1997 to 69.0% in 2005. Forty-seven (7.4%) infants died; 30 (8.7%) in the vaginal, 9 (6.4%) in the emergency, and 8 (5.4%) in the elective CD group. There was no difference in rate of proven infection, duration of ventilation, or length of neonatal intensive care unit stay between the 3 groups. After controlling for prematurity, low birth weight, and outborn birth, the risk for neonatal demise was similar in both the vaginal and CD infants (adjusted hazard ratio, 1.486; 95% confidence interval, 0.814-2.713; P = .197). Stratifying the CD (emergency vs elective) gave similar results. CONCLUSION: Infants with gastroschisis appear to be safely delivered vaginally.
Authors:
Mohamed E Abdel-Latif; Srinivas Bolisetty; Samanthi Abeywardana; Kei Lui;
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of pediatric surgery     Volume:  43     ISSN:  1531-5037     ISO Abbreviation:  J. Pediatr. Surg.     Publication Date:  2008 Sep 
Date Detail:
Created Date:  2008-09-09     Completed Date:  2009-02-11     Revised Date:  2009-04-16    
Medline Journal Info:
Nlm Unique ID:  0052631     Medline TA:  J Pediatr Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1685-90     Citation Subset:  IM    
Affiliation:
Department of Newborn Care, Royal Hospital for Women, Randwick, NSW 2031, Australia.
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MeSH Terms
Descriptor/Qualifier:
Adult
Australia
Cesarean Section
Delivery, Obstetric*
Emergency Treatment
Female
Gastroschisis / mortality*
Humans
Infant, Newborn
Male
New Zealand
Retrospective Studies
Survival Rate
Comments/Corrections
Comment In:
J Pediatr Surg. 2009 Mar;44(3):657-8; author reply 658-9   [PMID:  19302878 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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