Morbidity in infants with antenatally-diagnosed anterior abdominal wall defects

The aims of this study were to compare the morbidity of infants with gastro schisis (GS) with that of infants with exomphalos (EX) without lethal abnor malities and to identify factors predictive of adverse outcome: a requireme nt for parenteral nutrition (PN) for over 1 month and hospital admission fo r over 2 months. The medical records of 45 infants with anterior wall defec ts (32 with GS) diagnosed antenatally who consecutively received intensive care in one institution from 1993 were reviewed. Both the GS and EX infants had a median gestational age of 37 weeks, but the former were lighter at b irth (P < 0.01). Fourteen infants (all with GS) were able to start feeds on ly after 2 weeks; 10 (8 with GS) developed liver dysfunction; and 5 (all wi th GS) died. The GS compared to the EX infants required a longer period of PN (median 20 vs 10 days, P < 0.01) and longer hospital admission (median 4 0 vs 25 days, P < 0.01). In the GS group the time to start feeding related independently to prolonged hospital stay, and the existence of structural b owel abnormalities (SBA) related independently to both measures of adverse outcome, with a positive predictive value of 100%. We conclude that infants with GS, particularly those with SBA, suffer greater morbidity than infant s with EX without lethal abnormalities.