{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T19:04:47Z","timestamp":1774465487399,"version":"3.50.1"},"reference-count":26,"publisher":"Springer Science and Business Media LLC","issue":"6","license":[{"start":{"date-parts":[[2021,2,2]],"date-time":"2021-02-02T00:00:00Z","timestamp":1612224000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,2,2]],"date-time":"2021-02-02T00:00:00Z","timestamp":1612224000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100005744","name":"Lastentautien Tutkimuss\u00e4\u00e4ti\u00f6","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100005744","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur J Pediatr"],"published-print":{"date-parts":[[2021,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The aim of the present study was to assess the prognostic factors for the outcome of gastroschisis in Finland. A retrospective multicenter study of gastroschisis patients born between 1993 and 2015 in four Finnish university hospitals was undertaken, collecting perinatal, surgical, and clinical data of neonates for uni- and multifactorial modeling analysis. The aim of the present study was to identify risk factors for mortality and the composite adverse outcome (death and\/or short bowel syndrome or hospital stay &gt; 60 days). Of the 154 infants with gastroschisis, the overall survival rate was 90.9%. In Cox regression analysis, independent risk factors for mortality included liver herniation, pulmonary hypoplasia, relaparotomy for perforation or necrosis, abdominal compartment syndrome, and central line sepsis. Furthermore, a logistic regression analysis identified central line sepsis, abdominal compartment syndrome, complex gastroschisis, and a younger gestational age as independent predictors of the composite adverse outcome.<\/jats:p><jats:p><jats:italic>Conclusion<\/jats:italic>: The risk of death is increased in newborns with gastroschisis who have liver herniation, pulmonary hypoplasia, abdominal compartment syndrome, relaparotomy for perforation or necrosis, or central line\u2013associated sepsis. Special care should be taken to minimize the risk of central line sepsis in the clinical setting.<jats:table-wrap><jats:table><jats:tbody>\n                    <jats:tr>\n                      <jats:td colspan=\"2\"><jats:bold>What is known:<\/jats:bold>\u2022 <jats:italic>Gastroschisis is a relatively rare congenital anomaly of the abdominal wall and its incidence is increasing<\/jats:italic>.\u2022 <jats:italic>Complex gastroschisis has been reported to increase risk of mortality and complications<\/jats:italic>.<jats:bold>What is new:<\/jats:bold>\u2022 <jats:italic>Central line sepsis was found to be independently associated with mortality in gastroschisis patients<\/jats:italic>.\u2022 <jats:italic>Liver herniation was also significantly associated with mortality<\/jats:italic>.<\/jats:td>\n                    <\/jats:tr>\n                  <\/jats:tbody><\/jats:table><\/jats:table-wrap><\/jats:p>","DOI":"10.1007\/s00431-021-03964-w","type":"journal-article","created":{"date-parts":[[2021,2,2]],"date-time":"2021-02-02T23:02:42Z","timestamp":1612306962000},"page":"1875-1883","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["The association of perinatal and clinical factors with outcomes in infants with gastroschisis\u2014a retrospective multicenter study in Finland"],"prefix":"10.1007","volume":"180","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4189-6424","authenticated-orcid":false,"given":"Asta","family":"Tauriainen","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ulla","family":"Sankilampi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arimatias","family":"Raitio","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tuomas","family":"Tauriainen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ilkka","family":"Helenius","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kari","family":"Vanamo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna","family":"Hyv\u00e4rinen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2021,2,2]]},"reference":[{"key":"3964_CR1","first-page":"423","volume":"7538","author":"P Mastroiacovo","year":"2006","unstructured":"Mastroiacovo P, Lisi A, Castilla EE (2006) The incidence of gastroschisis: research urgently needs resources. BMJ. 7538:423\u2013424","journal-title":"BMJ."},{"key":"3964_CR2","doi-asserted-by":"publisher","unstructured":"Raitio A, Lahtinen A, Syv\u00e4nen J, Kemppainen T, L\u00f6yttyniemi E, Gissler M et al (2019) Gastroschisis in Finland 1993 to 2014 -increasing prevalence, high rates of abortion, and survival: a population-based study. Eur J Pediatr Surg. https:\/\/doi.org\/10.1055\/s-0039-3401797 Online ahead of print","DOI":"10.1055\/s-0039-3401797"},{"key":"3964_CR3","doi-asserted-by":"publisher","first-page":"1725","DOI":"10.1080\/14767058.2018.1529163","volume":"10","author":"A Brebner","year":"2020","unstructured":"Brebner A, Czuzoj-Shulman N, Abenhaim HA (2020) Prevalence and predictors of mortality in gastroschisis: a population-based study of 4803 cases in the USA. J Matern Fetal Neonatal Med 10:1725\u20131731","journal-title":"J Matern Fetal Neonatal Med"},{"key":"3964_CR4","doi-asserted-by":"publisher","first-page":"23","DOI":"10.15585\/mmwr.mm6502a2","volume":"65","author":"AM Jones","year":"2016","unstructured":"Jones AM, Isenburg J, Salemi JL, Arnold KE, Mai CT, Aggarwal D, Arias W, Carrino GE, Ferrell E, Folorunso O, Ibe B, Kirby RS, Krapfl HR, Marengo LK, Mosley BS, Nance AE, Romitti PA, Spadafino J, Stock J, Honein MA (2016) Increasing prevalence of gastroschisis-14 states, 1995-2012. MMWR Morb Mortal Wkly Rep 65:23\u201326","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"3964_CR5","doi-asserted-by":"publisher","first-page":"162","DOI":"10.1002\/ajmg.c.30181","volume":"03","author":"EE Castilla","year":"2008","unstructured":"Castilla EE, Mastroiacovo P, Orioli IM (2008) Gastrochisis: international epidemiology and public health perspectives. Am J Med Genet C: Semin Med Genet 03:162\u2013179","journal-title":"Am J Med Genet C: Semin Med Genet"},{"key":"3964_CR6","doi-asserted-by":"publisher","first-page":"1682","DOI":"10.1016\/j.jpedsurg.2013.01.021","volume":"8","author":"M van Manen","year":"2013","unstructured":"van Manen M, Hendson L, Wiley M, Evans M, Taghaddos S, Dinu I (2013) Early childhood outcomes of infants born with gastroschisis. J Pediatr Surg 8:1682\u20131687","journal-title":"J Pediatr Surg"},{"key":"3964_CR7","doi-asserted-by":"publisher","first-page":"217","DOI":"10.1016\/j.jss.2019.07.065","volume":"245","author":"SL Raymond","year":"2020","unstructured":"Raymond SL, Hawkins SB, St Peter SD, Downard C, Qureshi FG, Renaud E et al (2020) Predicting morbidity and mortality in neonates born with gastroschisis. J Surg Res 245:217\u2013224","journal-title":"J Surg Res"},{"key":"3964_CR8","doi-asserted-by":"publisher","first-page":"30","DOI":"10.1016\/j.jpedsurg.2007.09.011","volume":"1","author":"ED Skarsgard","year":"2008","unstructured":"Skarsgard ED, Claydon J, Bouchard S, Kim PCW, Lee SK, Laberge J-M et al (2008) Canadian pediatric surgical network: a population-based pediatric surgery network and database for analyzing surgical birth defects. The first 100 cases of gastroschisis. J Pediatr Surg 1:30\u201334","journal-title":"J Pediatr Surg"},{"key":"3964_CR9","doi-asserted-by":"publisher","first-page":"1520","DOI":"10.1016\/j.jpedsurg.2007.04.032","volume":"9","author":"MA Arnold","year":"2007","unstructured":"Arnold MA, Chang DC, Nabaweesi R, Colombani PM, Bathurst MA, Mon KS et al (2007) Risk stratification of 4344 patients with gastroschisis into simple and complex categories. J Pediatr Surg 9:1520\u20131525","journal-title":"J Pediatr Surg"},{"key":"3964_CR10","doi-asserted-by":"publisher","first-page":"192","DOI":"10.1016\/j.jpeds.2017.06.013","volume":"188","author":"BS Fullerton","year":"2017","unstructured":"Fullerton BS, Velazco CS, Sparks EA, Morrow KA, Edwards EM, Soll RF, Modi BP, Horbar JD, Jaksic T (2017) Contemporary outcomes of infants with gastroschisis in North America: a multicenter cohort study. J Pediatr 188:192\u2013197","journal-title":"J Pediatr"},{"key":"3964_CR11","doi-asserted-by":"publisher","first-page":"1972","DOI":"10.1016\/j.jpedsurg.2017.08.066","volume":"12","author":"SM Koehler","year":"2017","unstructured":"Koehler SM, Szabo A, Loichinger M, Peterson E, Christensen M, Wagner AJ (2017) The significance of organ prolapse in gastroschisis. J Pediatr Surg 12:1972\u20131976","journal-title":"J Pediatr Surg"},{"key":"3964_CR12","doi-asserted-by":"publisher","first-page":"2115","DOI":"10.1016\/j.jpedsurg.2011.07.010","volume":"11","author":"EB McClellan","year":"2011","unstructured":"McClellan EB, Shew SB, Lee SS, Dunn JCY, Deugarte DA (2011) Liver herniation in gastroschisis: incidence and prognosis. J Pediatr Surg 11:2115\u20132118","journal-title":"J Pediatr Surg"},{"key":"3964_CR13","doi-asserted-by":"crossref","unstructured":"von Elm E, Altman DG, Egger M, Pocock SJ, Gotzsche PC, Vandenbroucke JP et al (2014) The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: guidelines for reporting observational studies. Int J Surg 12:1495\u20131499","DOI":"10.1016\/j.ijsu.2014.07.013"},{"key":"3964_CR14","doi-asserted-by":"publisher","first-page":"446","DOI":"10.3109\/07853890.2013.803739","volume":"5-6","author":"U Sankilampi","year":"2013","unstructured":"Sankilampi U, Hannila M-L, Saari A, Gissler M, Dunkel L (2013) New population-based references for birth weight, length, and head circumference in singletons and twins from 23 to 43 gestation weeks. Ann Med 5-6:446\u2013454","journal-title":"Ann Med"},{"key":"3964_CR15","doi-asserted-by":"publisher","first-page":"804","DOI":"10.1210\/jc.2006-2017","volume":"92","author":"P Clayton","year":"2007","unstructured":"Clayton P, Cianfarani S, Czernichow P, JohanssonG RR, Rogol A (2007) Management of the child born small for gestational age through to adulthood: a consensus statement of the International Societies of Pediatric Endocrinology and the Growth Hormone Research Society. J Clin Endocrinol Metab 92:804\u2013810","journal-title":"J Clin Endocrinol Metab"},{"key":"3964_CR16","doi-asserted-by":"publisher","first-page":"51","DOI":"10.1053\/jpsu.2001.20004","volume":"1","author":"KA Molik","year":"2001","unstructured":"Molik KA, Gingalewski CA, West KW, Rescorla FJ, Scherer LR, Engum SA et al (2001) Fetal gastroschisis: a plea for risk categorization. J Pediatr Surg 1:51\u201355","journal-title":"J Pediatr Surg"},{"key":"3964_CR17","doi-asserted-by":"publisher","first-page":"50","DOI":"10.1038\/sj.jp.7211616","volume":"1","author":"F Abdullah","year":"2007","unstructured":"Abdullah F, Arnold MA, Nabaweesi R, Fischer AC, Colombani PM, Anderson KD et al (2007) Gastroschisis in United States 1988-2003: analysis and risk categorization of 4,344 patients. J Perinatol 1:50\u201355","journal-title":"J Perinatol"},{"key":"3964_CR18","doi-asserted-by":"publisher","first-page":"286","DOI":"10.1016\/j.jpedsurg.2019.10.028","volume":"55","author":"AN Snyder","year":"2020","unstructured":"Snyder AN, Burjonrappa S (2020) Central line associated blood stream infections in gastroschisis patients: a nationwide database analysis of risks, outcomes and disparities. J Pediatr Surg 55:286\u2013291","journal-title":"J Pediatr Surg"},{"key":"3964_CR19","doi-asserted-by":"publisher","first-page":"632","DOI":"10.1016\/0022-3468(90)90350-I","volume":"6","author":"JP Roberts","year":"1990","unstructured":"Roberts JP, Gollow IJ (1990) Central venous catheter in surgical neonates. J Pediatr Surg 6:632\u2013634","journal-title":"J Pediatr Surg"},{"key":"3964_CR20","unstructured":"The Finnish institute of Health and Welfare: https:\/\/sampo.thl.fi\/pivot\/prod\/fi\/siro\/vvpospublic\/summary_sirovvpos. Accessed on 7th of December, 2020."},{"key":"3964_CR21","doi-asserted-by":"publisher","unstructured":"Kaussen T, Steinau G, Srinivasan PK, Otto J, Sasse M, Staudt F et al (2012) Recognition and management of abdominal compartment syndrome among German pediatric intensivists: results of a national survey. Ann Intensive Care 2. https:\/\/doi.org\/10.1186\/2110-5820-2-s1-s8","DOI":"10.1186\/2110-5820-2-s1-s8"},{"key":"3964_CR22","doi-asserted-by":"publisher","first-page":"789","DOI":"10.1016\/j.jpedsurg.2005.01.043","volume":"40","author":"M Olesevich","year":"2005","unstructured":"Olesevich M, Lexander F, Khan M, Cotman K (2005) Gastroschisis revisited: role of intraoperative measurement of abdominal pressure. J Pediatr Surg 40:789\u2013792","journal-title":"J Pediatr Surg"},{"key":"3964_CR23","first-page":"759","volume":"6","author":"JN Kidd","year":"2003","unstructured":"Kidd JN, Jackson RJ, Smith SD, Wagner CW (2003) Evolution of staged versus primary closure of gastroschisis. Ann Surg 6:759\u2013765","journal-title":"Ann Surg"},{"key":"3964_CR24","doi-asserted-by":"publisher","first-page":"81","DOI":"10.1136\/fn.81.2.F81","volume":"81","author":"H Porter","year":"1999","unstructured":"Porter H (1999) Pulmonary hypoplasia. Arch Dis Child Fetal Neonatal Ed 81:81\u201383","journal-title":"Arch Dis Child Fetal Neonatal Ed"},{"key":"3964_CR25","doi-asserted-by":"publisher","first-page":"319","DOI":"10.1007\/s00383-009-2342-x","volume":"4","author":"RP Davis","year":"2009","unstructured":"Davis RP, Treadwell MC, Drongowski RA, Teitelbaum DH, Mychaliska GB (2009) Risk factor in gastroschisis: can prenatal evaluation or early postnatal factors predict outcome? Pediatr Surg Int 4:319\u2013325","journal-title":"Pediatr Surg Int"},{"key":"3964_CR26","first-page":"22","volume":"2","author":"M Ghionzoli","year":"2012","unstructured":"Ghionzoli M, James CP, David AL, Shah D, Tan AWC, Iskaros J et al (2012) Gastroschisis with intestinal atresia \u2013 predictive value of antenatal diagnosis and outcome of postnatal treatment. J Pediatr Surg 2:22\u201328","journal-title":"J Pediatr Surg"}],"container-title":["European Journal of Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00431-021-03964-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00431-021-03964-w\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00431-021-03964-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,5,7]],"date-time":"2021-05-07T20:32:08Z","timestamp":1620419528000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00431-021-03964-w"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,2,2]]},"references-count":26,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2021,6]]}},"alternative-id":["3964"],"URL":"https:\/\/doi.org\/10.1007\/s00431-021-03964-w","relation":{},"ISSN":["0340-6199","1432-1076"],"issn-type":[{"value":"0340-6199","type":"print"},{"value":"1432-1076","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,2,2]]},"assertion":[{"value":"8 October 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"18 January 2021","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"22 January 2021","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"2 February 2021","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The institutional review boards of the university hospitals and the Finnish Institution for Health and Welfare accepted the study (THL\/206\/5.05.00\/2017). The work described has been carried out in accordance with The Code of Ethics of the World Medical Association (Declaration of Helsinki) for experiments involving humans.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"The need for patients\u2019 written consent was deemed unnecessary by the institutional review boards as we did not contact the families to conduct this retrospective study.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}},{"value":"All authors have given their consent to publish the manuscript.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"IH received grants from Medtronic and K2M outside of the submitted work. Other authors have nothing to disclose.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interests"}}]}}