Factors associated with death in newborns with gastroschisis: a retrospective cohort study from a single reference center.

Objective: The objective of this study was to assess the risk factors for neonatal death in newborns with gastroschisis.

Methods: Hospital-based secondary analysis of a retrospective cohort study was performed in a single reference center between January 2014 and December 2023. The following variables were evaluated: maternal characteristics, obstetric aspects, habits, and labor and delivery data. Information on neonatal and hospitalization was also included.

Results: A total of 48 newborns with gastroschisis were delivered, with 27 (56%) being discharged from the hospital, 5 (10%) being transferred to another hospital, and 16 (33%) dying. Maternal origin was associated with neonatal death, with a 4.2 times greater chance of death if the pregnant women came from the interior. Newborns who died started prenatal care significantly earlier than the survivors. Newborns with complex gastroschisis had a 4.05 times higher risk of death, while the lack of primary closure in the first approach increased this risk by a factor of 7.0. Duration of parenteral nutrition, admission to the neonatal intensive care unit, and total hospital stay were significantly shorter in the cases of death, indicating that longer periods were associated with a 5, 6, and 6% reduction in the risk of death, respectively. On the other hand, not wearing the oxygen hood helmet increased the risk of death by 6.94 times. Newborns who spent more days on mechanical ventilation were 9% more likely to die.

Conclusion: In conclusion, the only significant variable was the longer time on mechanical ventilation, which was associated with mortality in newborns with gastroschisis.