Infants With Omphalocele vs Gastroschisis Have Higher GI and Hepatobiliary Tract Anomalies

newborn infant in hospital
Researchers sought to determine demographic characteristics, cooccurring GI and hepatobiliary tract anomalies, and more in infants with omphalocele and gastroschisis.

Infants with omphalocele had more cooccurring gastrointestinal (GI) and hepatobiliary tract anomalies than infants with gastroschisis, according to study results published in Pediatrics and Neonatology.

Researchers retrospectively reviewed the records of babies born at MacKay Children’s Hospital in Taiwan between 2000 and 2020. Babies (N=51) born with congenital anomalies of omphalocele or gastroschisis were evaluated for coexisting hepatobiliary tract anomalies and clinical outcomes.

The omphalocele (n=30) and gastroschisis (n=21) cohorts were born at the gestational ages of 35 and 35 weeks; mothers had a mean age of 33±6.2 and 22±2.8 years (P <.001); 60.0% and 76.2% of babies were diagnosed in utero; 23.3% and 57.1% were small for gestational age (P =.020); and 50% and 28.6% were boys, respectively.

Twelve infants with omphalocele and 7 with gastroschisis had 11 and 5 cooccurring GI and hepatobiliary tract anomalies, respectively. The most common coexisting anomalies were malrotation (n=7), Meckel diverticulum (n=5), midgut volvulus (n=3), and intestinal atresia (n=3).

The omphalocele and gastroschisis groups received an average of 36.1 and 47.4 days of parenteral nutrition; they stayed in the hospital for 51.0 and 66.7 days; 43.3% and 66.7% had complications; and 16.7% and 4.8% did not survive, respectively.

After surgical intervention, the gastroschisis (n=14) cohort was associated with more cases of sepsis (42.9% vs 13.3%; P =.024) and tended to be associated with more cases of short bowel syndrome (14.3% vs 0%; P =.064) and small bowel perforation (14.3% vs 0%; P =.064) compared with the omphalocele (n=13) cohort, respectively.

Stratified by coexisting anomalies, patients without another condition tended to have shorter hospital stays (mean, 43.2 vs 81.4 days; P =.06).

Study limitations included the retrospective design and small sample size. Researchers noted that the small sample size was due to the rarity of the conditions.

“The diversity of coexisting [GI] and hepatobiliary tract anomalies was higher in the omphalocele group than in the gastroschisis group,” the study authors wrote. “In addition, we demonstrated that patients with gastroschisis or omphalocele had a higher rate of intestinal malrotation, midgut volvulus, and Meckel’s diverticulum than the general population. Therefore, the risk of volvulus should be evaluated and treated with caution when a patient has abdominal wall defects.”

Reference

Wen C-C, Kuo T-C, Lee H-C, et al. Coexisting gastrointestinal and hepatobiliary tract anomalies in omphalocele and gastroschisis: A 20-year experience in a single tertiary medical center. Pediatr Neonatol. Published online May 18, 2022. doi:10.1016/j.pedneo.2022.03.009