88 Growth and Neurodevelopmental Outcome of Infants with Abdominal Wall Defects

Infants with abdominal wall defects have significant neonatal mortality and morbidity however little data on longer term growth and neurodevelopmental outcome is available.

We wished to examine the long term growth and neurodevelopmental outcome of infants with gastroschisis and omphalocele, so that this information could be available for patient management and antenatal counseling.

All infants admitted to our tertiary care neonatal unit from September 2000 to Dec 2002 were included in the study.

39 infants with a diagnosis of abdominal wall defect, 25 with gastroschisis and 14 with omphalocele were admitted during the study period. There was no difference in birth weight or gestational age between the two diagnostic grops, although maternal age was significantly lower in the gastroschisis group (p<0.001). Three infants with gastroschisis died in the first year of life, 1 with sepsis and 2 with intestinal failure, and causes of death with omphalocele were chromosomal disorders (2), multiple congenital anomalies (1) and respiratory failure (1). One infant with gastroschisis received a liver transplant for cholestatic liver disease. Two infants were unable to attend for follow-up because of distance and 6 did not wish to attend. Follow-up data was available for 27 infants and they were followed for a mean age of 15.3 months, range 4.5–28 months. Growth and follow-up data is shown in Table. One child had a hearing deficit, and there were no cases of cerebral palsy. Minor cognitive delay was defined as MDI 70–84 on Bayley Scale of Infant Development, and major cognitive delay as MDI<70.

Infants with abdominal wall defects, in particular with omphalocele, have persistent feeding problems and developmental delay, thus careful follow-up is recommended.