Increased incidence of cardiac anomalies in pregnancies complicated by gastroschisis

Abstract

The purpose of this study was to determine the incidence of congenital heart defects (CHD) in infants with gastroschisis. Infants with gastroschisis repair were identified from California hospital discharge data during the years 1992 to 1997. The frequency of concomitant diagnosis of CHD and other demographic, neonatal, and pregnancy outcomes were examined. Sixty-nine of the 621 infants had a diagnosis of CHD, with 16 having more than 1 lesion. Excluding cases possibly attributable to persistent fetal circulation, 25 infants with CHD remained, for an incidence rate of 4%. There was a significant (P = .014) increase in incidence of CHD in cases of gastroschisis complicated by bowel atresia. African American infants with gastroschisis had an increased risk of CHD (P = .009) compared with infants of other ethnicities. Contrary to conventional teaching that gastroschisis is an isolated anomaly, we found an increased incidence of concomitant CHD. Our data would suggest that detailed antepartum and/or postnatal cardiac evaluations are indicated in fetuses identified with gastroschisis.