Influence of associated malformations on survival rate of surgically uncomplicated esophageal atresia cases

Abstract

The influence of birthweight, gestational age, and associated malformations on the survival rate was studied in cases of uncomplicated esophageal atresia. A collective of 66 infants (birthweight: 2856.9±506 g; gestational age: 38.9±1.5 weeks) was randomly selected from a registry we established on esophageal atresia, and which currently involves 311 infants. The inclusion criteria were: 1) birth data after January 1975, and neonatal intensive care, 2) primary end-to-end anastomosis with fistula closure to provide comparable surgical procedures, 3) no neonatal complications to exclude a possible influence on the mortality rate. The mortality rate of the whole collective was 7.6%. All 42 patients without associated malformations survived (birthweight: 2871.1±482 g; gestational age: 38.9±1.5 weeks). The 24 cases with associated malformations, however, had a mortality rate of 20.8%; the infants who died had mean birthweights of 2684±796 g, and gestational ages of 38.1±1 weeks. Thus associated congenital malformations turned out to have a significant influence on the mortality rate of cases with esophageal atresia (p=0.0017). In a further, separate analysis of the particular malformations, cardiac malformations were found to be the only ones that significantly influenced mortality (p=0.0001). The gestational age and weight at birth were not predictive of the lemortality rate in cases of uncomplicated esophageal atresia, whereas the association with cardiac malformations significantly reduced the chances of survival.