Morbidity in children with gastroschisis: a population-based data linkage study

Background
Gastroschisis is the most common congenital abdominal wall defect. It has favourable mortality outcomes with most individuals surviving into adulthood, yet less is known about ongoing morbidity risks. This study aimed to examine morbidity outcomes particularly hospitalisations and surgeries in early childhood in children born with gastroschisis.

Methods
A population-based data linkage study of eight European congenital anomaly registries using their data on children with gastroschisis born between 1995 and 2014 and electronic health records. Five registries (Finland, Spain, Wales and two in Italy) included data from live-born children without congenital anomalies born during the same period (reference children). A descriptive analysis of hospitalisations, length of stay, and surgical data was conducted.

Results
We included data on 1028 children born with gastroschisis. 54.5% of these were born preterm (95% confidence intervals [CI] 51.4-57.6). Hospitalisations were highest in the first year of life across all registries but were also three times higher than the reference population at ages 1 to <5 years (pooled incidence rate ratio 2.9, 95% CI 1.9-4.5). Length of stay in hospital at ages 1 to <5 years was shorter than during the first year of life. Only 2.8% (95% CI 1.4-4.7) of hospitalisations in this age group lasted 10 days or more, compared with 89.8% (95% CI 86.8-92.4) in the first year of life, although results in the older children were variable across registries.

Conclusion
Children with gastroschisis experience high morbidity that continues beyond the first year of life and their initial surgery. Future research should focus on understanding morbidity risks according to the complexity of the anomaly. Research on the causes of hospitalisations after the first year of life will help provide information to plan future care for these children.