Eur J Pediatr Surg 2021; 31(02): 172-176
DOI: 10.1055/s-0040-1703012
Original Article

Omphalocele in Finland from 1993 to 2014: Trends, Prevalence, Mortality, and Associated Malformations—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 Tauriainen
3   Department of Paediatric Surgery, KYS, Kuopio, 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
,
Ulla Sankilampi
6   Department of Paediatrics, Kuopio University Hospital, Kuopio, Finland
,
Kari Vanamo
7   Department of Paediatric Surgery, Kuopio University Hospital, Kuopio, Pohjois-Savo, Finland
,
Mika Gissler
8   Department of Information Services, National Institute for Health and Welfare, Helsinki, Finland
9   Department of Neurobiology, Karolinska Institute, Stockholm, Stockholm County, Sweden
,
Anna Hyvärinen
10   Department of Paediatric Surgery, Tampere University Hospital, Tampere, Finland
11   Department of Medicine, 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
Funding This study was funded by Clinical Research Institute HUCH.

Abstract

Inroduction The aim of this study is to assess the changes in prevalence, mortality and termination pregnancy of omphalocele, and to identify associated anomalies.

Materials and Methods A population-based nationwide register study. All cases with omphalocele 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 perinatal and infant mortality and prevalence were calculated.

Results There were 600 cases with omphalocele including 229 live births, 39 stillbirths, and 332 (55%) abortions. Birth prevalence in Finland was 1.96 per 10,000 births with no consistent trend over time. However, total prevalence was much higher (4.71/10,000) because more than half of these families chose option for the termination of pregnancy. Omphalocele is often complicated with other anomalies; most commonly chromosomal abnormalities (9.3%), heart defects (6.3%), central nervous system anomalies (3.0%), gastrointestinal, and urogenital malformations (both 2.0%). Proportion of chromosomal and central nervous system abnormalities were even higher in terminated pregnancies. Overall infant mortality was 22%. Total 1-year survival rates for isolated omphalocele, cases with multiple anomalies and neonates with chromosomal defects were 80, 88, and 17%, respectively.

Conclusion Omphalocele is a rare congenital anomaly, often associated with other malformations. Our data suggest that isolated cases may be more common than previously thought. In the absence of chromosomal defects, survival is reasonably good. Regardless, more than half of these pregnancies are often terminated.



Publikationsverlauf

Eingereicht: 17. Oktober 2019

Angenommen: 27. Januar 2020

Artikel online veröffentlicht:
04. März 2020

© 2020. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 
  • References

  • 1 Yazbeck S, Ndoye M, Khan AH. Omphalocele: a 25-year experience. J Pediatr Surg 1986; 21 (09) 761-763
  • 2 Stoll C, Alembik Y, Dott B, Roth MP. Risk factors in congenital abdominal wall defects (omphalocele and gastroschisi): a study in a series of 265,858 consecutive births. Ann Genet 2001; 44 (04) 201-208
  • 3 Deng K, Qiu J, Dai L. et al. Perinatal mortality in pregnancies with omphalocele: data from the Chinese national birth defects monitoring network, 1996-2006. BMC Pediatr 2014; 14: 160
  • 4 Byron-Scott R, Haan E, Chan A, Bower C, Scott H, Clark K. A population-based study of abdominal wall defects in South Australia and Western Australia. Paediatr Perinat Epidemiol 1998; 12 (02) 136-151
  • 5 Springett A, Draper ES, Rankin J. et al. Birth prevalence and survival of exomphalos in england and wales: 2005 to 2011. Birth Defects Res A Clin Mol Teratol 2014; 100 (09) 721-725
  • 6 Li X, Dai L, Wang Y. et al. Long-term trends and seasonality of omphalocele during 1996-2010 in China: a retrospective analysis based on the hospital-based birth defects surveillance system. BMC Pregnancy Childbirth 2015; 15 (01) 102
  • 7 Gong TT, Wu QJ, Chen YL. et al. Evaluating the time trends in prevalence of exomphalos in 14 cities of Liaoning province, 2006 to 2015. Sci Rep 2016; 6: 32901
  • 8 ICBDSR office. Annual report 2011 with data for 2009. Roma, Italy: the international centre on birth defects-ICBDSR centre; 2011: 23-266 . Accessed February, 2020 at: http://www.icbdsr.org/wp-content/annual_report/Report2011.pdf
  • 9 Marshall J, Salemi JL, Tanner JP. et al; National Birth Defects Prevention Network. Prevalence, correlates, and outcomes of omphalocele in the united states, 1995–2005. Obstet Gynecol 2015; 126 (02) 284-293
  • 10 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
  • 11 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
  • 12 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
  • 13 Lakasing L, Cicero S, Davenport M, Patel S, Nicolaides KH. Current outcome of antenatally diagnosed exomphalos: an 11 year review. J Pediatr Surg 2006; 41 (08) 1403-1406
  • 14 Sikiöseulonta ja ultraäänitutkimukset | naistalo.fi | terveyskylä.fi. Published September 23, 2019. Accessed January 4, 2020 at: https://www.terveyskyla.fi/naistalo/raskaus-ja-synnytys/ultraäänitutkimukset-ja-sikiöseulonnat/sikiöseulonta-ja-ultraäänitutkimukset 2019
  • 15 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
  • 16 The Finnish register of congenital malformations. National institute for health and welfare. Accessed July 10, 2014 at: http://Www.thl.fi/en_US/web/en/statistics/topics/reproductive_health/congenital_anomalies
  • 17 Syvänen J, Nietosvaara Y, Ritvanen A, Koskimies E, Kauko T, Helenius I. High risk for major nonlimb anomalies associated with lower-limb deficiency: a population-based study. J Bone Joint Surg Am 2014; 96 (22) 1898-1904
  • 18 European surveillance of congenital anomalies. Accessed July 10, 2014 at: www.eurocat-network.eu
  • 19 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
  • 20 Campbell S. A short history of sonography in obstetrics and gynaecology. Facts Views Vis ObGyn 2013; 5 (03) 213-229
  • 21 Tan KH, Kilby MD, Whittle MJ, Beattie BR, Booth IW, Botting BJ. Congenital anterior abdominal wall defects in England and Wales 1987-93: retrospective analysis of OPCS data. BMJ 1996; 313 (7062): 903-906
  • 22 Stoll C, Alembik Y, Dott B, Roth MP. Omphalocele and gastroschisis and associated malformations. Am J Med Genet A 2008; 146A (10) 1280-1285
  • 23 Ionescu S, Mocanu M, Andrei B. et al. Differential diagnosis of abdominal wall defects - omphalocele versus gastroschisis. Chirurgia (Bucur) 2014; 109 (01) 7-14
  • 24 Greenwood RD, Rosenthal A, Nadas AS. Cardiovascular malformations associated with omphalocele. J Pediatr 1974; 85 (06) 818-821
  • 25 Fetology BD. Diagnosis and management of the fetal patient. New York: McGraw-Hill Medical Pub Division; 2010: 1004
  • 26 Klein M. Congenital defects of the abdominal wall. In: Coran AG, adzick NS. eds. Pediatric surgery. Philadelphia, PA: Elsevier/Saunders; 2012: 973-984
  • 27 Brantberg A, Blaas HG, Haugen SE, Eik-Nes SH. Characteristics and outcome of 90 cases of fetal omphalocele. Ultrasound Obstet Gynecol 2005; 26 (05) 527-537
  • 28 Kelhä M. Too old to become a mother? risk constructions in 35+ women's experiences of pregnancy, child-birth, and postnatal care. NORA 2009; 17 (02) 89-103
  • 29 Virgo S, Sear R. Evolution and human behavior. Evol Hum Behav 1997; 37 (05) 366-375
  • 30 Raitio A, Lahtinen A, Syvänen J. et al. Gastroschisis in finland 1993 to 2014-increasing prevalence, high rates of abortion, and survival: a population-based study. Eur J Pediatr Surg 2019
  • 31 Ples L, Popescu I, Margarit I. et al. Factors affecting the decision to undergo abortion in Romania: Experiences at our clinic. J Eval Clin Pract 2019
  • 32 Sutton A, Lichter DT, Sassler S. Rural-urban disparities in pregnancy intentions, births, and abortions among US adolescent and young women, 1995–2017. Am J Public Health 2019; 109 (12) 1762-1769
  • 33 Salihu HM, Pierre-Louis BJ, Druschel CM, Kirby RS. Omphalocele and gastroschisis in the State of New York, 1992-1999. Birth Defects Res A Clin Mol Teratol 2003; 67 (09) 630-636