Abstract
Objective: Some studies have pointed at maternal smoking as a causative factor for gastroschisis. To our knowledge no study has investigated the role of maternal smoking on outcome of gastroschisis patients. The aim was to compare postnatal outcome of gastroschisis patients of smoking and non-smoking mothers. Methods: We conducted an observational study based on data from the institutional registry of neonatal surgery and chart review including all fetuses with a prenatal diagnosis of gastroschisis between January 1990 and February 2005 (n = 68). Maternal smoking habits during the first half of the pregnancy were recorded. Long term survival (censoring date 15.04.2005) was checked by census data. The main endpoints were postnatal mortality and morbidity of the gastroschisis patients. Statistical analyses were performed by SPSS 12.0. Results: Two pregnancies were terminated and 1 fetus died inutero. Sixty-five babies were live born; 21 (32.3%) mothers were smokers, 44 (67.7%) were non-smokers. The smoker/nonsmoker groups did not differ significantly concerning maternal age (24.2 vs. 24.5 years), percentage of nullipara (76.2 vs. 68.2%), time of diagnosis (21.5 vs. 21.8 weeks), percentage Cesarean deliveries (90.5 vs. 68.2% p = 0.07), gestational age at delivery (36.1 vs. 36.4 weeks), birth weight (2604 vs. 2716 g), 1 min (6.9 vs. 7.3) and 5 min Apgar scores (8.0 vs. 8.5) and associated major anomalies (14.3 vs. 20.5%). Primary closure was performed in 90.5 vs. 79.5%, p = 0.48 and the frequency of reoperation for complications was 19.0 vs. 39.5%, p = 0.16 (smoker vs. nonsmoker). Neonatal survival was 85.7 vs. 97.7% (p = 0.095) in the smoker vs. non-smoker groups, respectively. Long term survival was significantly decreased in the smoking group; 76.2 vs. 95.5%, p = 0.031 (smoker/non-smoker). Conclusion: Maternal smoking in early pregnancy was associated with a tendency to reduced neonatal and long term survival.
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