期刊论文详细信息
BMC Pediatrics
Perinatal mortality in pregnancies with omphalocele: data from the Chinese national birth defects monitoring network, 1996–2006
Jun Zhu2  Yi Mu1  Changfei Deng1  Ling Yi1  Li Dai1  Jie Qiu3  Kui Deng2 
[1] National Center for Birth Defects monitoring of China, West China Second University Hospital, Sichuan University, 17, Section3, Ren Min South Road, Chengdu, China;Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China;Department of Maternal and Children Health, National Health and Family Planning Commission of the People's Republic of China, Beijing, China
关键词: Ultrasound;    Prenatal diagnosis;    Associated anomalies;    Perinatal outcome;    Mortality;    Abdominal wall defects;    Omphalocele;   
Others  :  1138676
DOI  :  10.1186/1471-2431-14-160
 received in 2013-09-03, accepted in 2014-06-12,  发布年份 2014
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【 摘 要 】

Background

Previous studies on the mortality rate of omphalocele are limited. The risk of death of non-isolated omphalocele and that of cases of omphalocele that are diagnosed prenatally by ultrasound are unclear. This study aimed to estimate the perinatal mortality of pregnancies with omphalocele. This study also examined the potential risk of death of non-isolated omphalocele and that of cases that are prenatally diagnosed by ultrasound.

Methods

Data were retrieved from the national birth defects registry in China, for 1996–2006. Multinomial logistic regression was used to calculate the adjusted odds ratios (AORs) and 95% confidence intervals (CIs) between perinatal mortality and selected maternal and fetal characteristics.

Results

Among 827 cases of omphalocele, 309 (37.4%) cases resulted in termination of pregnancy and stillbirth, and 124 (15.0%) cases resulted in death in the first 7 days after delivery, yielding a perinatal mortality rate of 52.4% (95% CI: 49.0–55.8%). The late fetal death rate (LFDR) of omphalocele that was diagnosed prenatally by ultrasound was 15.91-fold (AOR: 15.91, 95% CI: 10.18–24.87) higher than that of postnatally diagnosed cases. The LFDR of non-isolated omphalocele was 2.64-fold (AOR: 2.64, 95% CI: 1.62–4.29) higher than that of isolated cases. For the early neonatal death rate, neonates with non-isolated omphalocele had a 2.96-fold (AOR: 2.96, 95% CI: 1.82–4.81) higher risk than isolated cases, but the difference between prenatal ultrasound diagnosis and postnatal diagnosis was not significant.

Conclusions

Selected fetal characteristics are significantly associated with the perinatal risk of death from omphalocele. Our findings suggest that improving pregnancy and delivery care, as well as management for omphalocele are important.

【 授权许可】

   
2014 Deng et al.; licensee BioMed Central Ltd.

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【 参考文献 】
  • [1]Ledbetter DJ: Gastroschisis and omphalocele. Surg Clin North Am 2006, 86(2):249-260. vii
  • [2]Wilson RD, Johnson MP: Congenital abdominal wall defects: an update. Fetal Diagn Ther 2004, 19(5):385-398.
  • [3]Calzolari E, Bianchi F, Dolk H, Milan M, EUROCAT Working Group: Omphalocele and gastroschisis in Europe: a survey of 3 million births 1980-1990. Am J Med Genet 1995, 58(2):187-194.
  • [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(2):136-151.
  • [5]Forrester MB, Merz RD: Epidemiology of abdominal wall defects, Hawaii, 1986-1997. Teratology 1999, 60(3):117-123.
  • [6]Rankin J, Dillon E, Wright C: Congenital anterior abdominal wall defects in the north of England, 1986-1996: occurrence and outcome. Prenat Diagn 1999, 19(7):662-668.
  • [7]Suita S, Okamatsu T, Yamamoto T, Handa N, Nirasawa Y, Watanabe Y, Yanagihara J, Nishijima E, Hirobe S, Nio M, Gomi A, Horisawa M: Changing profile of abdominal wall defects in Japan: results of a national survey. J Pediatr Surg 2000, 35(1):66-71. discussion 72
  • [8]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(9):630-636.
  • [9]Tan KB, Tan KH, Chew SK, Yeo GS: Gastroschisis and omphalocele in Singapore: a ten-year series from 1993 to 2002. Singapore Med J 2008, 49(1):31-36.
  • [10]Zhou GX, Liang J, Zhu J, Dai L, Wang YP, Miao L: An epidemiological study on omphalocele in China during 1996 to 2000. Zhonghua Yu Fang Yi Xue Za Zhi 2004, 38(5):328-330.
  • [11]Kominiarek MA, Zork N, Pierce SM, Zollinger T: Perinatal outcome in the live-born infant with prenatally diagnosed omphalocele. Am J Perinatol 2011, 28(8):627-634.
  • [12]Brantberg A, Blaas HG, Haugen SE, Eik-Nes SH: Characteristics and outcome of 90 cases of fetal omphalocele. Ultrasound Obstet Gynecol 2005, 26(5):527-537.
  • [13]Boyd PA, Bhattacharjee A, Gould S, Manning N, Chamberlain P: Outcome of prenatally diagnosed anterior abdominal wall defects. Arch Dis Child Fetal Neonatal Ed 1998, 78(3):F209-F213.
  • [14]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(8):1403-1406.
  • [15]Sermer M, Benzie RJ, Pitson L, Carr M, Skidmore M: Prenatal diagnosis and management of congenital defects of the anterior abdominal wall. Am J Obstet Gynecol 1987, 156(2):308-312.
  • [16]Christison-Lagay ER, Kelleher CM, Langer JC: Neonatal abdominal wall defects. Semin Fetal Neonatal Med 2011, 16(3):164-172.
  • [17]Mitanchez D, Walter-Nicolet E, Humblot A, Rousseau V, Revillon Y, Hubert P: Neonatal care in patients with giant ompholocele: arduous management but favorable outcomes. J Pediatr Surg 2010, 45(8):1727-1733.
  • [18]Islam S: Clinical care outcomes in abdominal wall defects. Curr Opin Pediatr 2008, 20(3):305-310.
  • [19]Garne E, Loane M, Dolk H, Group EW: Gastrointestinal malformations: impact of prenatal diagnosis on gestational age at birth. Paediatr Perinat Epidemiol 2007, 21(4):370-375.
  • [20]Cohen-Overbeek TE, Tong WH, Hatzmann TR, Wilms JF, Govaerts LC, Galjaard RJ, Steegers EA, Hop WC, Wladimiroff JW, Tibboel D: Omphalocele: comparison of outcome following prenatal or postnatal diagnosis. Ultrasound Obstet Gynecol 2010, 36(6):687-692.
  • [21]Dai L, Zhu J, Liang J, Wang YP, Wang H, Mao M: Birth defects surveillance in China. World J Pediatr 2011, 7(4):302-310.
  • [22]International Clearinghouse for Birth Defects Surveillance and Research: International Clearinghouse for Birth Defects Surveillance and Research Annual report 2012. Roma, Italy: The Internaltional Center on Birth Defects - ICBDSR Center; 2012. http://www.icbdsr.org/filebank/documents/ar2005/Report2012.pdf webcite (accessed June 21, 2013)
  • [23]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(4):201-208.
  • [24]Barisic I, Clementi M, Hausler M, Gjergja R, Kern J, Stoll C: Evaluation of prenatal ultrasound diagnosis of fetal abdominal wall defects by 19 European registries. Ultrasound Obstet Gynecol 2001, 18(4):309-316.
  • [25]Heider AL, Strauss RA, Kuller JA: Omphalocele: clinical outcomes in cases with normal karyotypes. Am J Obstet Gynecol 2004, 190(1):135-141.
  • [26]Mann S, Blinman TA, Douglas Wilson R: Prenatal and postnatal management of omphalocele. Prenat Diagn 2008, 28(7):626-632.
  • [27]Paidas MJ, Crombleholme TM, Robertson FM: Prenatal diagnosis and management of the fetus with an abdominal wall defect. Semin Perinatol 1994, 18(3):196-214.
  • [28]Stoll C, Tenconi R, Clementi M: Detection of congenital anomalies by fetal ultrasonographic examination across Europe. Community Genet 2001, 4(4):225-232.
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