The influence of gestational age and mode of delivery on infants with gastroschisis

Background/Purpose: It has been proposed that preterm and prelabor cesarean section may improve the outcome of infants with gastroschisis. The purpose of this study is to examine the impact of gestation and delivery method on infants with gastroschisis. Methods: The medical records of 60 infants with gastroschisis treated at a tertiary care center from 1985 through 1995 were reviewed retrospectively. The gestational age, the mode of delivery, the type of operative repair, and the length of hospital stay were recorded for each patient. Results: Infants born vaginally were more likely to require silo stage repair than those delivered by cesarean section (21 of 29 v 11 of 31, P<.01). Infants born vaginally also had longer hospital stay than those delivered by cesarean section (53 v 39 days, P=.19). Infants born before 33 weeks' of gestation stayed longer in the hospital than those born after 33 weeks. After 33 weeks' gestation, infants had similar hospital stay regardless of the gestational age. Conclusions: Cesarean section delivery was beneficial for infants with gastroschisis. Preterm delivery did not shorten the length of hospital stay. The role of elective cesarean section delivery at term should be considered for infants with gastroschisis diagnosed antenatally. J Pediatr Surg 34:1393-1395. Copyright (C) 1999 by W.B. Saunders Company.