Perinatal predictors of outcome in gastroschisis

Objective:to identify perinatal risk variables predictive of outcome in gastroschisis.study design:gastroschisis cases were collected over a 3-year period from a national database. risk variables evaluated included gestational age (ga), birth weight, time of birth, admission illness severity (score for neonatal acute physiology-ii, snap-ii) score, and abdominal closure type. mortality and survival outcomes were analyzed. multivariate analyses were performed.result:in all, 239 infants were survived (96%). snap-ii score predicted mortality (relative risk (rr)=1.07, 95% confidence interval (ci)=1.0 to 1.1). length of hospital stay (los) and ventilation days were predicted by ga and by snap-ii score. snap-ii score predicted total parenteral nutrition (tpn) days (p=0.006). severe cholestasis (conjugated bilirubin of >10 mg per 100 ml) was inversely related to ga (rr=0.77, 95% ci=0.61 to 0.97) and directly to categorical snap-ii score (rr=3.4, 95% ci=1.2 to 10.1). urgent closure predicted fewer tpn days (p=0.003) and shorter los (p=0.0002).conclusion:snap-ii scores significantly predict mortality and survival outcomes. urgent closure favors fewer tpn days and shorter los. our data refute routine preterm delivery in gastroschisis.