IS A NORMALLY FUNCTIONING GASTROINTESTINAL-TRACT NECESSARY FOR NORMALGROWTH IN LATE-GESTATION

It is known that neonates with congenital abnormalities of the intesti ne tend to be growth-retarded. We wished to explore the hypothesis tha t normal fetal gut function is needed for normal growth in late gestat ion. If this is true, then different populations of babies with differ ent congenital gut abnormalities would be expected to have similar imp airments of growth and be small at birth. This growth retardation woul d be more marked in term than in preterm babies and would be independe nt of other congenital anomalies. To test these hypotheses, we examine d 43 babies born with gastroschisis (GS) in Auckland, New Zealand; 69 babies born with GS in Birmingham, England; and 60 babies born with in testinal atresia (IA) in Auckland. For Auckland babies with GS, the me an weight standard deviation score (WSDS) (i.e., birth weight relative to the mean birth weight for gestation) for term babies was lower tha n that for preterm babies (-0.932 +/- 0.180 vs -0.064 +/- 0.237, P = 0 .014). This was also true for Birmingham babies with GS (-0.991 +/- 0. 193 vs -0.36 +/- 0.153, P = 0.028). For babies with IA, the mean WSDS for term babies was lower than that for preterm babies (-0.627 +/- 0.2 66 vs 0.057 +/- 0.211, P = 0.034). There was no significant difference between the mean WSDS of babies with and without major congenital abn ormalities (-0.402 +/- 0.201 vs -0.271, P = 0.70). Our results demonst rate that term babies born with GS are significantly growth-retarded c ompared with premature babies born with GS. Term babies born with a pr oximal IA are also growth-retarded. This strongly suggests that in lat e gestation, the normal growth is dependent on a normally functioning gastrointestinal tract that allows exposure of the proximal intestinal mucosa to ingested amniotic fluid.