Outcomes of multi-gestational pregnancies affected by esophageal atresia – tracheoesophageal fistula

Space: StayCurrentMD Author: Corey Forster, Paul Zamiara, Eveline Lapidus-Krol, Monping Chiang, Vikki Scaini, Beth Haliburton, Aideen M. Moore, Margaret A. Marcon, Priscilla P.L. Chiu Published:

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Corey Forster, Paul Zamiara, Eveline Lapidus-Krol, Monping Chiang, Vikki Scaini, Beth Haliburton, Aideen M. Moore, Margaret A. Marcon, Priscilla P.L. Chiu

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Abstract

Background

Contemporary outcomes of infants with esophageal atresia with or without tracheoesophageal fistula (EA/TEF) from multi-gestational pregnancies compared to those of singleton pregnancies have not been reported.

Methods

A single-center retrospective review of EA/TEF patients born from 1999 to 2013 was performed. Patient demographics, gestational age (GA), birth weight, associated anomalies, requirement for gastrostomy tube and mortality were reviewed.

Results

Singleton EA/TEF patients outnumbered those from multi-gestational pregnancies nearly 10:1 (214 vs 22 patients). EA/TEF patients from multi-gestational pregnancies were more likely to be premature (77% vs. 32%), have lower birth weight (mean 1766 g vs. 2695 g), have associated duodenal atresia (18% vs. 6%) and require gastrostomy tube (41% vs. 33%) for feeding challenges compared to EA/TEF singletons. Mortality was also significantly greater for multi-gestational EA/TEF patients compared to singleton EA/TEF patients (18% vs. 6%). Conclusion: EA/TEF infants from multi-gestational pregnancies have greater clinical complexity and mortality than singleton EA/TEF patients. Parents of EA/TEF multi-gestational infants should be appropriately counseled and supported.

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