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Dávila Romero V, Aragón Mendoza RL, Molina-Giraldo S, Herrera EM, Leal EH, Gallo Roa R, Rodríguez Ortiz JA, Toro AM, Peña RR, Gómez Hoyos D, Nudelman T, Vargas Fiallo CL. Factors of poor prognosis in newborns with a prenatal diagnosis of gastroschisis in Bogota, Colombia. J Perinat Med 2024; 52:665-670. [PMID: 38758017 DOI: 10.1515/jpm-2023-0520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Accepted: 04/06/2024] [Indexed: 05/18/2024]
Abstract
OBJECTIVES To identify factors associated with poor prognoses in newborns with a prenatal diagnosis of gastroschisis in eight hospitals in Bogota, Colombia, from 2011 to 2022. METHODS A multi-center retrospective case-control study was conducted on newborns with gastroschisis in eight hospitals in Bogota, Colombia. Poor prognosis was defined as the presence of sepsis, intestinal complications, or death. RESULTS The study included 101 patients. Preterm newborns under 32 weeks had a poor neonatal prognosis (OR 6.78 95 % CI 0.75-319). Oligohydramnios (OR 4.95 95 % CI 1.15-21.32) and staged closure with silo (OR 3.48; 95 % CI 1.10-10.96) were risk factors for neonatal death, and intra-abdominal bowel dilation of 20-25 mm was a factor for the development of intestinal complications (OR 3.22 95 % CI 1.26-8.23). CONCLUSIONS Intra-abdominal bowel dilation between 20 and 25 mm was associated with intestinal complications, while oligohydramnios was associated with the risk of perinatal death, requiring increased antenatal surveillance of fetal wellbeing. Management with primary reduction when technically feasible is recommended in these infants, considering that the use of silos was associated with higher mortality.
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Affiliation(s)
- Viviana Dávila Romero
- Obstetrics and Gynecology Department, 27989 Universidad de La Sabana, Hospital Universitario de La Samaritana , Bogotá, Colombia
| | - Rafael L Aragón Mendoza
- Obstetrics and Gynecology Department, 150244 GINECOHUS Research Group, Hospital Universitario de la Samaritana , Bogotá, Colombia
| | - Saulo Molina-Giraldo
- Sección de Terapia Fetal y Unidad de Cirugía Fetal, División de Medicina Materno Fetal, Obstetrics and Gynecology Department, Clínica Colsubsidio 94, Red de Investigación en Terapia y Cirugía Fetal - FetoNetwork Colombia, Bogotá, Colombia
- Unidad de Medicina Materno Fetal, Departamento Ginecología y Obstetricia Facultad de Medicina, Universidad Nacional De Colombia, Bogotá, Colombia
| | - Emiliano M Herrera
- Clínica Universitaria Colombia and Clínica Pediátrica Colsanitas, Bogotá, Colombia
| | - Elman H Leal
- Obstetrics and Gynecology Department, 150244 GINECOHUS Research Group, Hospital Universitario de la Samaritana , Bogotá, Colombia
| | - Roberto Gallo Roa
- Obstetrics and Gynecology Department, 150244 GINECOHUS Research Group, Hospital Universitario de la Samaritana , Bogotá, Colombia
| | | | - Angelica M Toro
- Obstetrics and Gynecology Department, 173049 Hospital Universitario San Ignacio , Bogotá, Colombia
| | - Rafael R Peña
- Pediatric Surgery Department, 221984 Hospital Universitario Clínica San Rafael , Bogota, Colombia
| | - Diana Gómez Hoyos
- Neonatology Department, 221984 Hospital Universitario Clínica San Rafael , Bogota, Colombia
| | - Tammy Nudelman
- Neonatology Department, 221984 Hospital Universitario Clínica San Rafael , Bogota, Colombia
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Krieck LK, Barbian MH, Schuler-Faccini L, Pinto Moehlecke Iser B. Congenital anomalies in Santa Catarina, Southern Brazil: macroregional and temporal birth prevalence for the period 2011-2020. J Community Genet 2024:10.1007/s12687-024-00716-9. [PMID: 38918275 DOI: 10.1007/s12687-024-00716-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Accepted: 06/17/2024] [Indexed: 06/27/2024] Open
Abstract
Congenital anomalies (CAs) are an important cause of infant mortality and efficient surveillance is necessary for their prevention. Therefore, the objective of this study is to establish baselines of prevalence at birth of priority CAs for surveillance in the state of Santa Catarina, using data from the Live Birth Information System considering the period 2011-2019 (baseline) and 2020 (pandemic year). The analyses were carried out based on the mother's residence health macroregion. The CAs were selected following the ICD-10 coding for chapter XVII. Birth prevalence was calculated per 10,000 live births and the confidence interval was established at 95%. 2011-2019 recorded 88.8/10,000 births with CAs (total). For 2011-2019, limb defects (without polydactyly) were the most prevalent (14.1/10,000), followed by congenital heart defects (8.9), oral clefts (8.2), polydactyly (7.9), Down syndrome (5.6), hypospadias (5.4), neural tube defects (4.7), gastroschisis (3.3), undefined sex (1.2), microcephaly (0.8) and omphalocele (0.3). There were no significant differences in temporal and spatial distribution. However, unusual fluctuations were observed in 2020, which may reflect the pandemic in CAs notifications. In the base period, Santa Catarina recorded CAs below the expected level of being identified at birth. With this, we conclude that the training and awareness of teams are essential for the surveillance of CAs in Santa Catarina.
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Affiliation(s)
- Laysa Kariny Krieck
- Graduate Program in Genetics and Molecular Biology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Márcia Helena Barbian
- Graduate Program in Statistics, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Lavinia Schuler-Faccini
- Graduate Program in Genetics and Molecular Biology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
- Medical Genetics Service, Hospital de Clínicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
| | - Betine Pinto Moehlecke Iser
- Graduate Program in Health Sciences, Universidade do Sul de Santa Catarina, Tubarão, Santa Catarina, Brazil.
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Egger PA, de Souza MP, Riedo CDO, Dutra ADC, da Silva MT, Pelloso SM, Carvalho MDDB. Gastroschisis annual incidence, mortality, and trends in extreme Southern Brazil. J Pediatr (Rio J) 2022; 98:69-75. [PMID: 34115974 PMCID: PMC9432054 DOI: 10.1016/j.jped.2021.04.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 03/06/2021] [Accepted: 04/02/2021] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVE To analyze gastroschisis annual incidence, mortality rates, and trends in the Brazilian state of Rio Grande do Sul from the year 2000 to the year 2017. METHOD Population-based study with the analysis of the temporal trend of gastroschisis annual incidence and mortality rates. Data were obtained from the Live Birth Information System and the Mortality Information System, with the analysis performed by polynomial regression modeling. RESULTS There were 2,612,532 live births, 705 hospitalizations, and 233 deaths due to gastroschisis. The annual incidence of gastroschisis was 2.69 per 10,000 live births. The annual incidence rate increased by 85% in the total period (p = 0.003), and mortality was 33% in the 2000-2017 period. Maternal age < 25 years was a risk factor for gastroschisis (p < 0.001). Children were more likely to be born weighing < 2,500 g (p < 0.001) and with a gestational age < 37 weeks (p < 0.001). The annual incidence trend was to increase, and the mortality trend was to decrease. CONCLUSION Similar to what has been described in several regions/countries, there was a trend showing an 85% increase in the annual incidence of gastroschisis (p = 0.003) and the mortality was 33% with a trend of decreasing (p = 0.002).
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Affiliation(s)
- Paulo Acácio Egger
- Universidade Estadual de Maringá, Centro de Ciências da Saúde, Maringá, PR, Brazil.
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Calderon MG, Santos EFDS, Abreu LCD, Raimundo RD. Increasing prevalence, time trend and seasonality of gastroschisis in São Paulo state, Brazil, 2005-2016. Sci Rep 2019; 9:14491. [PMID: 31601921 PMCID: PMC6787234 DOI: 10.1038/s41598-019-50935-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Accepted: 09/20/2019] [Indexed: 11/09/2022] Open
Abstract
To estimate the gastroschisis seasonality and trend of prevalence in recent years, stratified by maternal age and geographical clusters of São Paulo state, a population-based study was designed. We used data from the Live Births Information System (SINASC) in São Paulo state, Brazil, from 2005 to 2016. Trends of prevalence were evaluated for the specific subgroups using the Prais-Winsten regression model, and the Durbin-Watson test was used, to estimate the regression coefficient, the annual percent change (APC), and 95% confidence interval (CI). We observed 1576 cases of gastroschisis among 7,317,657 live births (LB), a prevalence of 2.154 (95% CI: 2.047-2.260) per 10,000 LB which included, 50.6% males, 67.4% Caucasians, 53.4% preterm births, and 80.9% caesarean births. The prevalence of gastroschisis significantly increased by 2.6% (95% CI: 0.0-5.2) per year, and this trend was higher in mothers aged 30-34 years (APC: 10.2, 95% CI: 1.4-19.4) than in mothers of other age groups. Between 2011 and 2016, we identified the existence of seasonality based on the date of conception in the middle months of the year (p = 0.002). This is the first and largest population-based study summarizing current epidemiology and identifying trend of prevalence of gastroschisis in São Paulo state.
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Affiliation(s)
- Mauricio Giusti Calderon
- Study Design and Scientific Writing Laboratory, Centro Universitário Saúde ABC, Av. Príncipe de Gales, 667. 2 floor, Santo André, 09060-870, SP, Brazil.
| | - Edige Felipe de Sousa Santos
- Study Design and Scientific Writing Laboratory, Centro Universitário Saúde ABC, Av. Príncipe de Gales, 667. 2 floor, Santo André, 09060-870, SP, Brazil
- Epidemiology Department, Faculdade de Saúde Pública da Universidade de São Paulo (USP), São Paulo, SP, Brazil
| | - Luiz Carlos de Abreu
- Study Design and Scientific Writing Laboratory, Centro Universitário Saúde ABC, Av. Príncipe de Gales, 667. 2 floor, Santo André, 09060-870, SP, Brazil
- Public Policy and Local Development, Escola Superior de Ciências da Santa Casa de Misericórdia, Vitória, ES, Brazil
- Graduate Entry Medical School, University of Limerick, Limerick, Ireland
| | - Rodrigo Daminello Raimundo
- Study Design and Scientific Writing Laboratory, Centro Universitário Saúde ABC, Av. Príncipe de Gales, 667. 2 floor, Santo André, 09060-870, SP, Brazil
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Feldkamp ML, Arnold KE, Krikov S, Reefhuis J, Almli LM, Moore CA, Botto LD. Risk of gastroschisis with maternal genitourinary infections: the US National birth defects prevention study 1997-2011. BMJ Open 2019; 9:e026297. [PMID: 30928950 PMCID: PMC6475179 DOI: 10.1136/bmjopen-2018-026297] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE To assess the association between occurrence and timing of maternal self-reported genitourinary tract infection (urinary tract infections [UTIs] and/or sexually transmitted infection [STI]) and risk for gastroschisis in the offspring. DESIGN Population-based case-control study. SETTING National Birth Defects Prevention Study, a multisite study in the USA. PARTICIPANTS Mothers of 1366 gastroschisis cases and 11 238 healthy controls. MAIN OUTCOME MEASURES Crude and adjusted ORs (aORs) with 95% CIs. RESULTS Genitourinary infections were frequent in case (19.3%) and control women (9.9%) during the periconceptional period (defined as 3 months prior to 3 months after conception). UTI and/or STI in the periconceptional period were associated with similarly increased risks for gastroschisis (aOR 1.5, 95% CI 1.3 to 1.8; aOR 1.6, 95% CI 1.2 to 2.3, respectively). The risk was increased with a UTI before (aOR 2.5; 95% CI 1.4 to 4.5) or after (aOR 1.7; 95% CI 1.1 to 2.6) conception only among women ≥25 years of age. The risk was highest among women <20 years of age with an STI before conception (aOR 3.6; 95% CI 1.5 to 8.4) and in women ≥25 years of age, the risk was similar for before (aOR 2.9; 95% CI 1.0 to 8.5) and after (aOR 2.8; 95% CI 1.3 to 6.1) conception. A specific STI pathogen was reported in 89.3% (50/56) of cases and 84.3% (162/191) of controls with Chlamydia trachomatis the most common (25/50 cases, 50%; 58/162 controls, 36%) and highest among women <20 years of age (16/25 cases, 64%; 22/33 controls, 67%). CONCLUSIONS UTI and/or STI were associated with an increased risk for gastroschisis, with the strength of the association varying by maternal age and timing of infection.
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Affiliation(s)
- Marcia L Feldkamp
- Division of Medical Genetics, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Kathryn E Arnold
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Sergey Krikov
- Division of Medical Genetics, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Jennita Reefhuis
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Lynn M Almli
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
- Carter Consulting, Inc, Atlanta, Georgia, USA
| | - Cynthia A Moore
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Lorenzo D Botto
- Division of Medical Genetics, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, Utah, USA
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Watanabe S, Suzuki T, Hara F, Yasui T, Uga N, Naoe A. Omphalocele and Gastroschisis in Newborns: Over 16 Years of Experience from a Single Clinic. J Neonatal Surg 2017; 6:27. [PMID: 28770124 PMCID: PMC5538593 DOI: 10.21699/jns.v6i2.530] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2017] [Accepted: 02/22/2017] [Indexed: 11/17/2022] Open
Abstract
Infants born with potentially life-threatening conditions of omphalocele and gastroschisis may require long-term hospitalization. We aimed to compare the outcomes of these two conditions occurring over a 16-year period (2001-16). It is a retrospective study of 19 newborns undergoing surgery for these two abdominal wall defects (8 patients with omphalocele and 11 cases of gastroschisis). The average birth weights for the newborns with omphaloceles and gastroschisis were 2554.5 g and 2248.6 g respectively. Associated anomalies included trisomy 18, Beckwith-Wiedemann syndrome, congenital heart disease, Meckel’s diverticulum, inguinal hernias, renal deformities, limb deformities, cryptorchidism, body stalk anomalies, and closed gastroschisis. The average hospital stay for the newborns with omphaloceles and gastroschisis were 42.6 days 50.2 days respectively. The time to the start of postoperative nutritional supplementation for the newborns with omphaloceles and gastroschisis were 4.3 days for the infants with omphaloceles and 7.3 days for respectively. The survival rates for the newborns with omphaloceles and gastroschisis were similar, 87.5% and 81.8% respectively. Survival rates in omphalocele correlated negatively with associated anomalies. In gastroschisis cases, strict care is necessary when intestinal dilation is observed via fetal sonography.
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Affiliation(s)
| | - Tatuya Suzuki
- Department of Pediatric Surgery, Fujita Health University, Japan
| | - Fujio Hara
- Department of Pediatric Surgery, Fujita Health University, Japan
| | - Toshihiro Yasui
- Department of Pediatric Surgery, Fujita Health University, Japan
| | - Naoko Uga
- Department of Pediatric Surgery, Fujita Health University, Japan
| | - Atuki Naoe
- Department of Pediatric Surgery, Fujita Health University, Japan
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