Outcomes of newborns with gastroschisis: The effects of mode of delivery, site of delivery, and interval from birth to surgery

Abstract

OBJECTIVE: Our purpose was to determine the impact of delivery site, delivery mode, and delivery-to-surgery interval on outcomes for neonates diagnosed with gastroschisis. STUDY DESIGN: Data were obtained retrospectively by chart review on 56 newborns diagnosed with gastroschisis. Outcome measures examined included primary closure, days to enteral feeding, days in intensive care, total length of stay, and hospital charges. RESULTS: Inborn infants experienced fewer days to enteral feeding ( p < 0.01), shorter total lengths of hospital stay ( p < 0.01), and lower hospital charges ( p < 0.01). Newborns delivered by cesarean section tended to have longer lengths of stay ( p = 0.07), greater hospital charges ( p = 0.06), and significantly longer lengths of stay in intensive care ( p = 0.05). Shorter intervals from delivery to surgery were observed for inborn neonates ( p < 0.01) and for those delivered by cesarean section ( p < 0.05). No relationships between hours from delivery to surgery and neonatal outcomes were observed. CONCLUSIONS: Delivery at a regional center is associated with improved outcomes, whereas cesarean deliveries were associated with worse outcomes. We observed no salutary effect related to the interval between delivery and initial surgical repair. (A M J O BSTET G YNECOL 1996;174:1134-40.)