Risk Factors for Mortality of Newborns with Gastroschisis in a Tertiary Hospital of Taiwan

Several risk factors have previously been reported to be associated with adverse outcome in infants with gastroschisis, these include mode of delivery, site of delivery, in utero diagnosis, type of closure, delayed surgery, prematurity, low birth weight, and concurrent anomalies. The purpose of this study was to determine the mortality rate and to identify risk factors associated with mortality in infants with gastroschisis in a tertiary hospital in Taiwan. The medical records of 44 infants with gastroschisis treated at National Taiwan University Hospital from 1991 to 2001 were retrospectively reviewed. The survival rate and odds ratio were determined for the following: prenatal factors (maternal age, gestational age, birth body weight, in utero diagnosis, mode of delivery, and site of delivery), preoperative factors (birth to admission interval, birth to surgery interval, operative method, concurrent anomalies), and postoperative factors (duration of mechanical ventilation use, duration of total parenteral nutritional support, and postoperative complications). The overall mortality rate was 20% (9/44). Neither perinatal nor preoperative factors were correlated with survival. Among the postoperative factors, only the presence of postoperative complications correlated with mortality, especially infection and renal events. In contrast to studies reported in other countries, postoperative infection and renal complications were the only significant risk factors for neonatal mortality with gastroschisis treated in a medical center in Taiwan.