Eur J Pediatr Surg 2020; 30(06): 536-540
DOI: 10.1055/s-0039-3401797
Original Article

Gastroschisis in Finland 1993 to 2014—Increasing Prevalence, High Rates of Abortion, and Survival: A Population-Based Study

1   Department of Paediatric Surgery and Orthopaedics, Turku University Hospital, Turku, Finland
2   Department of Paediatric Surgery and Orthopaedics, University of Turku Faculty of Medicine, Turku, Finland
,
Asta Lahtinen
3   Department of Paediatric Surgery, Kuopio University Hospital, Kuopio, Pohjois-Savo, Finland
,
Johanna Syvänen
1   Department of Paediatric Surgery and Orthopaedics, Turku University Hospital, Turku, Finland
2   Department of Paediatric Surgery and Orthopaedics, University of Turku Faculty of Medicine, Turku, Finland
,
Teemu Kemppainen
4   Department of Biostatistics, University of Turku, Turku, Finland
5   Department of Biostatistics, Turku University Hospital, Turku, Finland
,
Eliisa Löyttyniemi
4   Department of Biostatistics, University of Turku, Turku, Finland
5   Department of Biostatistics, Turku University Hospital, Turku, Finland
,
Mika Gissler
6   Information Services Department, National Institute for Health and Welfare, Helsinki, Finland
7   Department of Neurobiology, Karolinska Institute, Stockholm, Stockholm County, Sweden
,
Anna Hyvärinen
8   Department of Paediatric Surgery, Tampere University Hospital, Tampere, Finland
9   Department of Paediatric Surgery, Tampere University Faculty of Medicine, Tampere, Finland
,
Ilkka Helenius
1   Department of Paediatric Surgery and Orthopaedics, Turku University Hospital, Turku, Finland
2   Department of Paediatric Surgery and Orthopaedics, University of Turku Faculty of Medicine, Turku, Finland
› Institutsangaben

Abstract

Introduction The study aims to assess the changes in prevalence and mortality of gastroschisis, and to identify associated anomalies.

Materials and Methods It is a population-based nationwide study. All gastroschisis cases were identified in the Finnish Register of Congenital Malformations and the Care Register for Health Care from 1993 to 2014 including live births, stillbirths, and terminations of pregnancy due to fetal anomalies. Associated anomalies were recorded, and analyzed, and prevalence and infant mortality were calculated.

Results There were 320 cases of gastroschisis; 235 (73%) live births, 16 (5%) stillbirths, and 69 (22%) terminations of pregnancy. Live birth prevalence of gastroschisis in Finland was lower than generally reported (1.73 in 10,000). However, due to relatively high rates of abortion, our total prevalence of 2.57/10,000 was similar with other reports. The most common risk factor was young maternal age. Babies with gastroschisis were born prematurely, on average on the 36th week and most are delivered by caesarean section. There was a significant increasing trend in live birth prevalence (p = 0.0018). Overall infant mortality was 7.7% (18/235), 7.2% (16/222) in simple gastroschisis and 15% (2/13) in complex gastroschisis. Associated anomalies were rare both in aborted fetuses and neonates, and there was only one case with a chromosomal abnormality.

Conclusion Gastroschisis is usually an isolated anomaly with increasing birth prevalence and excellent survival rates. Regardless of the good prognosis, the abortion rates in Finland are higher than previously reported, and we hypothesize this to be due to lack of appropriate antenatal counselling.



Publikationsverlauf

Eingereicht: 28. August 2019

Angenommen: 01. April 2019

Artikel online veröffentlicht:
31. Dezember 2019

© 2020. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 
  • References

  • 1 Bergholz R, Boettcher M, Reinshagen K, Wenke K. Complex gastroschisis is a different entity to simple gastroschisis affecting morbidity and mortality—a systematic review and meta-analysis. J Pediatr Surg 2014; 49 (10) 1527-1532
  • 2 Bhatt P, Lekshminarayanan A, Donda K. et al. Trends in incidence and outcomes of gastroschisis in the United States: analysis of the national inpatient sample 2010-2014. Pediatr Surg Int 2018; 34 (09) 919-929
  • 3 Garne E, Loane M, Dolk H. et al. Prenatal diagnosis of severe structural congenital malformations in Europe. Ultrasound Obstet Gynecol 2005; 25 (01) 6-11
  • 4 Benjamin B, Wilson GN. Registry analysis supports different mechanisms for gastroschisis and omphalocele within shared developmental fields. Am J Med Genet A 2015; 167A (11) 2568-2581
  • 5 Akhtar J, Skarsgard ED. Canadian Pediatric Surgery Network (CAPSNet). Associated malformations and the “hidden mortality” of gastroschisis. J Pediatr Surg 2012; 47 (05) 911-916
  • 6 Fleurke-Rozema H, van de Kamp K, Bakker M, Pajkrt E, Bilardo C, Snijders R. Prevalence, timing of diagnosis and pregnancy outcome of abdominal wall defects after the introduction of a national prenatal screening program. Prenat Diagn 2017; 37 (04) 383-388
  • 7 Anderson JE, Galganski LA, Cheng Y. et al. Epidemiology of gastroschisis: a population-based study in California from 1995 to 2012. J Pediatr Surg 2018; 53 (12) 2399-2403
  • 8 Castilla EE, Mastroiacovo P, Orioli IM. Gastroschisis: international epidemiology and public health perspectives. Am J Med Genet C Semin Med Genet 2008; 148C (03) 162-179
  • 9 Robledo-Aceves M, Bobadilla-Morales L, Mellín-Sánchez EL. et al. Prevalence and risk factors for gastroschisis in a public hospital from west México. Congenit Anom (Kyoto) 2015; 55 (02) 73-80
  • 10 Chabra S, Gleason CA, Seidel K, Williams MA. Rising prevalence of gastroschisis in Washington State. J Toxicol Environ Health A 2011; 74 (05) 336-345
  • 11 Vu LT, Nobuhara KK, Laurent C, Shaw GM. Increasing prevalence of gastroschisis: population-based study in California. J Pediatr 2008; 152 (06) 807-811
  • 12 Loane M, Dolk H, Bradbury I. EUROCAT Working Group. Increasing prevalence of gastroschisis in Europe 1980-2002: a phenomenon restricted to younger mothers?. Paediatr Perinat Epidemiol 2007; 21 (04) 363-369
  • 13 Rossi AC, Prefumo F. Accuracy of ultrasonography at 11-14 weeks of gestation for detection of fetal structural anomalies: a systematic review. Obstet Gynecol 2013; 122 (06) 1160-1167
  • 14 Brantberg A, Blaas HG, Salvesen KA, Haugen SE, Eik-Nes SH. Surveillance and outcome of fetuses with gastroschisis. Ultrasound Obstet Gynecol 2004; 23 (01) 4-13
  • 15 Nicholas SS, Stamilio DM, Dicke JM, Gray DL, Macones GA, Odibo AO. Predicting adverse neonatal outcomes in fetuses with abdominal wall defects using prenatal risk factors. Am J Obstet Gynecol 2009; 201 (04) 383.e1-383.e6
  • 16 Overcash RT, DeUgarte DA, Stephenson ML. et al; University of California Fetal Consortium. Factors associated with gastroschisis outcomes. Obstet Gynecol 2014; 124 (03) 551-557
  • 17 Brindle ME, Flageole H, Wales PW. Canadian Pediatric Surgery Network (CAPSNet). Influence of maternal factors on health outcomes in gastroschisis: a Canadian population-based study. Neonatology 2012; 102 (01) 45-52
  • 18 Brebner A, Czuzoj-Shulman N, Abenhaim HA. Prevalence and predictors of mortality in gastroschisis: a population-based study of 4803 cases in the USA. J Matern Fetal Neonatal Med 2018; DOI: 10.1080/14767058.2018.1529163.
  • 19 Lopez A, Benjamin RH, Raut JR. et al. Mode of delivery and mortality among neonates with gastroschisis: a population-based cohort in Texas. Paediatr Perinat Epidemiol 2019; 33 (03) 204-212
  • 20 Lao OB, Larison C, Garrison MM, Waldhausen JH, Goldin AB. Outcomes in neonates with gastroschisis in U.S. children's hospitals. Am J Perinatol 2010; 27 (01) 97-101
  • 21 Owen A, Marven S, Johnson P. et al; BAPS-CASS. Gastroschisis: a national cohort study to describe contemporary surgical strategies and outcomes. J Pediatr Surg 2010; 45 (09) 1808-1816
  • 22 Cowan KN, Puligandla PS, Laberge JM. et al; Canadian Pediatric Surgery Network. The gastroschisis prognostic score: reliable outcome prediction in gastroschisis. J Pediatr Surg 2012; 47 (06) 1111-1117
  • 23 Keys C, Drewett M, Burge DM. Gastroschisis: the cost of an epidemic. J Pediatr Surg 2008; 43 (04) 654-657
  • 24 Ekin A, Gezer C, Taner CE. et al. Fetal abdominal wall defects: six years experience at a tertiary center. Clin Exp Obstet Gynecol 2015; 42 (03) 327-330
  • 25 Greenlees R, Neville A, Addor MC. et al. Paper 6: EUROCAT member registries: organization and activities. Birth Defects Res A Clin Mol Teratol 2011; 91 (Suppl. 01) S51-S100
  • 26 The Finnish register of congenital malformations. national institute for health and welfare. Accessed July 10, 2004 at: http://www.thl.fi/en_US/web/en/statistics/topics/reproductive_health/congenital_anomalies
  • 27 European surveillance of congenital anomalies. Accessed July 10, 2014 at: www.eurocat-network.eu
  • 28 Jones AM, Isenburg J, Salemi JL. et al. Increasing prevalence of gastroschisis—14 states, 1995–2012. Morb Mortal Wkly Rep 2016; 65 (02) 23-26
  • 29 Hemminki K, Saloniemi I, Kyyrönen P, Kekomäki M. Gastroschisis and omphalocele in Finland in the 1970s: prevalence at birth and its correlates. J Epidemiol Community Health 1982; 36 (04) 289-293
  • 30 Draper ES, Rankin J, Tonks AM. et al. Recreational drug use: a major risk factor for gastroschisis?. Am J Epidemiol 2008; 167 (04) 485-491
  • 31 Yearbook of alcohol and drug statistics 2018. Accessed October 15, 2019 at: http://www.julkari.fi/handle/10024/1373322018
  • 32 Etelä-Suomen aluehallintovirasto, Vuorenmaa L, Ilola A, Mussalo-Rauhamaa H, & Hiltunen-Back E (2012). Sukupuolitaudit Suomessa eilen, tänään ja huomenna: Aktiivisia torjuntatoimia tarvitaan. Hämeenlinna: Etelä-Suomen aluehallintovirasto. Accessed October 15, 2019 at: https://www.avi.fi/documents/10191/149165/Sukupuolitaudit+Suomessa+eilen+tanaan+ja+huomenna/6d4060db-df05-4372-a4fc-6633b796fdb2
  • 33 Ahrens KA, Anderka MT, Feldkamp ML, Canfield MA, Mitchell AA, Werler MM. National Birth Defects Prevention Study. Antiherpetic medication use and the risk of gastroschisis: findings from the National Birth Defects Prevention Study, 1997-2007. Paediatr Perinat Epidemiol 2013; 27 (04) 340-345
  • 34 Rittler M, Castilla EE, Chambers C, Lopez-Camelo JS. Risk for gastroschisis in primigravidity, length of sexual cohabitation, and change in paternity. Birth Defects Res A Clin Mol Teratol 2007; 79 (06) 483-487
  • 35 Väisänen H, Helamaa T. The family federation of Finland. Accessed October 15, 2019 at: https://www.vaestoliitto.fi/tieto_ja_tutkimus/vaestontutkimuslaitos/tilastoja/perheet/uusperheet_suomessa/2014
  • 36 Hackshaw A, Rodeck C, Boniface S. Maternal smoking in pregnancy and birth defects: a systematic review based on 173 687 malformed cases and 11.7 million controls. Hum Reprod Update 2011; 17 (05) 589-604
  • 37 The Finnish Institute for Health and Welfare. Available at: http://Urn.fi/URN:NBN:Fi-fe2018102938947 2018
  • 38 South AP, Stutey KM, Meinzen-Derr J. Metaanalysis of the prevalence of intrauterine fetal death in gastroschisis. Am J Obstet Gynecol 2013; 209 (02) 114.e1-114.e13
  • 39 Kirollos DW, Abdel-Latif ME. Mode of delivery and outcomes of infants with gastroschisis: a meta-analysis of observational studies. Arch Dis Child Fetal Neonatal Ed 2018; 103 (04) F355-F363