Skip to main content
SpringerLink
Log in

The factors associated with successful early enteral feeding in gastroschisis

  • Original Article
  • Published:
Pediatric Surgery International Aims and scope Submit manuscript

Abstract

Background

Gastroschisis is the most common congenital abdominal wall defect. Due to the exposure of midgut to amniotic fluid, the recovery of bowel function is often delayed. This study aimed to identify the factors associated with the successful early enteral feeding in gastroschisis and to develop further guidelines of treatment.

Methods

A retrospective cohort study of gastroschisis babies from January 2006 to December 2015 was done. Exclusion criteria were incomplete data and death. Successful early enteral feeding was defined when full feeding was achieved within 21 days of life.

Results

One hundred and five gastroschisis patients were divided into a successful early-feeding group (n = 56, 53%) and a non-successful early-feeding group (n = 49, 46%). In multivariable analysis, significant factors for successful feeding clustered by primary treatment were female (RR = 1.38, P value < 0.001), gestational age > 36 weeks (RR = 1.23, P value < 0.001), age at surgery less than 10 h (RR = 1.15, P value < 0.001), postoperative extubation time < 4 days (RR = 1.39, P value < 0.001), and age when feeding started less than 10 days (RR = 35.69, P value < 0.001).

Conclusion

Several factors were found to be associated with successful early enteral feeding. The modifiable factors found in this study were surgery within 10 h, early postoperative extubation within 4 days, and feeding started before 10 days of life. These will guide the management of gastroschisis to achieve successful early enteral feeding.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Holland AJ, Walker K, Badawi N (2010) Gastroschisis: an update. Pediatr Surg Int 26(9):871–878

    Article  PubMed  Google Scholar 

  2. Aljahdali A, Mohajerani N, Skarsgard ED, Canadian Pediatric Surgery Network (2013) Effect of timing of enteral feeding on outcome in gastroschisis. J Pediatr Surg 48(5):971–976

    Article  PubMed  Google Scholar 

  3. Langer JC (1996) Gastroschisis and omphalocele. Semin Pediatr Surg 5(2):124–128

    PubMed  CAS  Google Scholar 

  4. Marinovic VM, Lukac ML, Mikovic Z, Grujic B, Stojanovic A, Sabbagh D, Samardzija G (2016) Gastroschisis with gastric perforation and jejunal stenosis. A rare association of anomalies. Ann Ital Chir 87:263–267

    PubMed  Google Scholar 

  5. Skarsgard ED (2016) Management of gastroschisis. Curr Opin Pediatr 28(3):363–369

    Article  PubMed  CAS  Google Scholar 

  6. Singh SJ, Fraser A, Leditschke JF et al (2003) Gastroschisis: determinants of neonatal outcome. Pediatr Surg Int 19(4):260–265

    Article  PubMed  CAS  Google Scholar 

  7. Allotey J, Davenport M, Njere I et al (2007) Benefit of preformed silos in the management of gastroschisis. Pediatr Surg Int 23(11):1065–1069

    Article  PubMed  CAS  Google Scholar 

  8. Lobo JD, Kim AC, Davis RP et al (2010) No free ride? The hidden costs of delayed operative management using a spring-loaded silo for gastroschisis. J Pediatr Surg 45(7):1426–1432

    Article  PubMed  Google Scholar 

  9. Alali JS, Tander B, Malleis J, Klein MD (2011) Factors affecting the outcome in patients with gastroschisis: how important is immediate repair? Eur J Pediatr Surg 21(2):99–102. https://doi.org/10.1055/s-0030-1267977

    Article  PubMed  CAS  Google Scholar 

  10. Novotny DA, Klein RL, Boeckman CR (1993) Gastroschisis: an 18-year review. J Pediatr Surg 28(5):650–652

    Article  PubMed  CAS  Google Scholar 

  11. Schlatter M, Norris K, Uitvlugt N, DeCou J, Connors R (2003) Improved outcomes in the treatment of gastroschisis using a preformed silo and delayed repair approach. J Pediatr Surg 38(3):459–464 (discussion 459–464)

    Article  PubMed  Google Scholar 

  12. Kunz SN, Tieder JS, Whitlock K, Jackson JC, Avansino JR (2013) Primary fascial closure versus staged closure with silo in patients with gastroschisis: a meta-analysis. J Pediatr Surg 48(4):845–857

    Article  PubMed  PubMed Central  Google Scholar 

  13. Schmidt AF, Gonçalves A, Bustorff-Silva JM, Oliveira Filho AG, Marba ST, Sbragia L (2011) Does staged closure have a worse prognosis in gastroschisis? Clinics 66(4):563–566

    Article  PubMed  PubMed Central  Google Scholar 

  14. Jager LC, Heij HA (2007) Factors determining outcome in gastroschisis: clinical experience over 18 years. Pediatr Surg Int 23(8):731–736

    Article  PubMed  Google Scholar 

  15. Snyder CW, Biggio JR, Bartle DT, Georgeson KE, Muensterer OJ (2011) Early severe hypoalbuminemia is an independent risk factor for intestinal failure in gastroschisis. Pediatr Surg Int 27(11):1155–1158

    Article  PubMed  Google Scholar 

  16. Miranda da Silva Alves F, Miranda ME, de Aguiar MJ, Bouzada Viana MC (2016) Nutritional management and postoperative prognosis of newborns submitted to primary surgical repair of gastroschisis. J Pediatr 92(3):268–275

    Article  Google Scholar 

  17. Maramreddy H, Fisher J, Slim M, Lagamma EF, Parvez B (2009) Delivery of gastroschisis patients before 37 weeks of gestation is associated with increased morbidities. J Pediatr Surg 44(7):1360–1366

    Article  PubMed  Google Scholar 

  18. Ergun O, Barksdale E, Ergun FS et al (2005) The timing of delivery of infants with gastroschisis influences outcome. J Pediatr Surg 40(2):424–428

    Article  PubMed  Google Scholar 

  19. Vilela PC, Ramos De Amorim MM, Falbo GH, Santos LC (2001) Risk factors for adverse outcome of newborns with gastroschisis in a Brazilian hospital. J Pediatr Surg 36(4):559–564

    Article  PubMed  CAS  Google Scholar 

  20. Berseth MCL (1992) Effect of early feeding on maturation of the preterm infant’s intestine. J Pediatr 120(6):947–953

    Article  PubMed  CAS  Google Scholar 

  21. Elizabeth Walter-Nicolet VR, Francois, Kieffer et al (2009) Neonatal outcome of gastroschisis is mainly influenced by nutritional management. J Pediatr Gastroenterol Nutr 48:612–617

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Pediatric Surgery, Department of Surgery, Chiang Mai University Hospital, 110 Intavaroros Road, Muang Chiang Mai District, Chiang Mai, 50200, Thailand

    Theerayuth Pratheeppanyapat, Kanokkan Tepmalai, Jesda Singhavejsakul & Jiraporn Khorana

Authors
  1. Theerayuth Pratheeppanyapat
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Kanokkan Tepmalai
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jesda Singhavejsakul
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Jiraporn Khorana
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jiraporn Khorana.

Ethics declarations

Conflict of interest

We report no conflicts of interest in this work.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Pratheeppanyapat, T., Tepmalai, K., Singhavejsakul, J. et al. The factors associated with successful early enteral feeding in gastroschisis. Pediatr Surg Int 34, 743–748 (2018). https://doi.org/10.1007/s00383-018-4282-9

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00383-018-4282-9

Keywords

Search

Navigation