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Prenatally diagnosed omphalocele: characteristics associated with adverse neonatal outcomes

Journal of Perinatology volume 39, pages 1111–1117 (2019)Cite this article

Subjects

Abstract

Objective

To characterize factors associated with adverse neonatal outcomes in prenatally diagnosed omphalocele cases.

Study design

Prenatally diagnosed omphalocele cases at a single referral center from 1 January 2009 to 31 December 2017 were retrospectively reviewed. Clinical variables and antenatal imaging measurements were collected. Associations between prenatal and neonatal characteristics and the adverse outcome of death or prolonged length of stay (LOS) were analyzed.

Results

Out of 63 fetal cases, 33 were live-born, > 50% had other anomalies, and neonatal mortality was 12%. Adverse outcomes were associated with neonatal variables, including lower median 1-min Apgar score, initial mechanical ventilation, and late-onset sepsis, but not approach to omphalocele closure. With multivariate analysis, death or prolonged LOS was associated only with low lung volumes by fetal MRI (OR 34 (3–422), p = 0.006).

Conclusion

Low lung volumes by fetal MRI were associated with death or prolonged LOS in neonates with prenatally diagnosed omphalocele and may guide clinicians with counseling families.

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Acknowledgements

The authors wish to thank the Fetal and Pregnancy Health Program at Stanford for facilitating identification of cases for this paper.

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Authors and Affiliations

  1. Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Palo Alto, CA, 94304, USA

    Valerie Y. Chock, Alexis S. Davis, Seo-Ho Cho, Elizabeth Fluharty, Nicole Weigel & Susan R. Hintz

  2. Fetal and Pregnancy Health Program, Lucile Packard Children’s Hospital Stanford, Palo Alto, CA, 94304, USA

    Valerie Y. Chock, Alexis S. Davis, Elizabeth Fluharty, Nicole Weigel, Margaret Homeyer, Louanne Hudgins, Erika Rubesova, Karl G. Sylvester, Yair J. Blumenfeld & Susan R. Hintz

  3. Stanford Prevention Research Center, Palo Alto, CA, 94305, USA

    Seo-Ho Cho

  4. Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA

    Christina Bax

  5. Division of Medical Genetics, Department of Pediatrics, Stanford University School of Medicine, Palo Alto, CA, 94304, USA

    Margaret Homeyer & Louanne Hudgins

  6. Department of Radiology, Stanford University School of Medicine, Palo Alto, CA, 94304, USA

    Richard Jones & Erika Rubesova

  7. Department of Pediatric Surgery, Stanford University School of Medicine, Palo Alto, CA, 94304, USA

    Karl G. Sylvester

  8. Department of Obstetrics and Gynecology, Maternal Fetal Medicine, Stanford University School of Medicine, Palo Alto, CA, 94304, USA

    Yair J. Blumenfeld

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  1. Valerie Y. Chock
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  2. Alexis S. Davis
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  9. Richard Jones
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  10. Erika Rubesova
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Correspondence to Valerie Y. Chock.

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Chock, V.Y., Davis, A.S., Cho, SH. et al. Prenatally diagnosed omphalocele: characteristics associated with adverse neonatal outcomes. J Perinatol 39, 1111–1117 (2019). https://doi.org/10.1038/s41372-019-0410-1

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