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

Arimatias Raitio; Asta Lahtinen; Johanna Syvänen; Teemu Kemppainen; Eliisa Löyttyniemi; Mika Gissler; Anna Hyvärinen; Ilkka Helenius

doi:10.1055/s-0039-3401797

European Journal of Pediatric Surgery, Table of Contents

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

Arimatias Raitio

¹Department of Paediatric Surgery and Orthopaedics, Turku University Hospital, Turku, Finland

²Department of Paediatric Surgery and Orthopaedics, University of Turku Faculty of Medicine, Turku, Finland

,

Asta Lahtinen

³Department of Paediatric Surgery, Kuopio University Hospital, Kuopio, Pohjois-Savo, Finland

,

Johanna Syvänen

¹Department of Paediatric Surgery and Orthopaedics, Turku University Hospital, Turku, Finland

²Department of Paediatric Surgery and Orthopaedics, University of Turku Faculty of Medicine, Turku, Finland

,

Teemu Kemppainen

⁴Department of Biostatistics, University of Turku, Turku, Finland

⁵Department of Biostatistics, Turku University Hospital, Turku, Finland

,

Eliisa Löyttyniemi

⁴Department of Biostatistics, University of Turku, Turku, Finland

⁵Department of Biostatistics, Turku University Hospital, Turku, Finland

,

Mika Gissler

⁶Information Services Department, National Institute for Health and Welfare, Helsinki, Finland

⁷Department of Neurobiology, Karolinska Institute, Stockholm, Stockholm County, Sweden

,

Anna Hyvärinen

⁸Department of Paediatric Surgery, Tampere University Hospital, Tampere, Finland

⁹Department of Paediatric Surgery, Tampere University Faculty of Medicine, Tampere, Finland

,

Ilkka Helenius

¹Department of Paediatric Surgery and Orthopaedics, Turku University Hospital, Turku, Finland

²Department of Paediatric Surgery and Orthopaedics, University of Turku Faculty of Medicine, Turku, Finland

› Author Affiliations

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.

Keywords

gastroschisis - birth prevalence - termination of pregnancy

Full Text

References

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