Assessment of gastroschisis risk factors in Egypt
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In brief
In brief
This Egyptian prospective study reveals 62% mortality in gastroschisis cases, primarily from sepsis and prematurity, with survival improving when transfer time is under 8 hours. Young maternal age and low socioeconomic status emerge as key risk factors, while the Gastroschisis Prognostic Score effectively predicts outcomes in resource-limited settings.
Written by the GCMD Library team from the article.
Aim
Mortality in infants born with gastroschisis (GS) in low-to-middle-income countries (LMICs) is high. This study aimed to assess factors which might affect outcome in Egypt in order to improve survival.
Methods
A prospective study over a 15-month duration was completed. Variables assessed covered patient, maternal, antenatal, treatment, and complications. The Gastroschisis Prognostic Score (GPS) was used to predict outcome. A validated questionnaire was used to assess socioeconomic status. The main outcome was mortality.
Results
Twenty-four cases were studied. Median gestational age was 37 (26–40) weeks, and 9 (38%) were preterm. Mortality occurred in 15 (62%) infants. Median transfer time was 8 (1.5–35) hours, and 64% survived if transferred before 8 h. Median maternal age was 20 (16–27) years. All families were of a low or very-low socioeconomic level. Only 25% had antenatal scans. Most cases were simple GS, and only 3 (12.5%) were complex GS. Median length of stay was 14 (1–52) days, TPN duration was 12 (0–49) days, and days to full feeds was 5 (3–11) days. The GPS score ranged from 0 to 6 in the studied cases and negatively correlated with outcome (rS = −0.98; p = 0.03).
Conclusion
The mortality of GS in Egypt is very high, mainly due to sepsis and prematurity. Young maternal age and poor socioeconomic status are linked to GS. The GPS is a good indicator of morbidity and mortality in a LMIC setting. Survival improved with better resuscitation and strict management protocols. More effort is needed to improve antenatal detection, and transfer time should be ideally below 8 h.
Level of Evidence
Level IV.