Early Closure of Gastroschisis After Silo Placement Correlates with Earlier Enteral Feeding

Abstract

Objectives: Gastroschisis is a congenital anomaly affecting 2.3-4.4/10,000 births. Previous studies show initiation of early enteral feeds predicts improved outcomes. We hypothesize that earlier definitive closure after silo placement; can lead to earlier enteral feed initiation. Design/ Setting/ Duration: Retrospective review of patients with gastroschisis from 2005 and 2014 at a single institution. Material and Methods: The data, including ethnicity, gestational age, birth weight, time to definitive closure, and time of first and full feeds, were analyzed using both Spearman’s rho and the Kruskal-Wallis rank sum test where appropriate; a p value <0.05 was considered significant. Results: Forty-three patients (24 males, 19 females) born with gastroschisis were identified. Overall survival rate was 88% (38/43). Forty of the 43 patients had a silo placed prior to definitive closure. Median days to closure were 6 (0 to 85) days. First feeds on average began on day of life (DOL) 17, and full feeds on DOL 25. Earlier closure of gastroschisis correlated with early initiation of feeds (p=0.0001) and shorter time to full feeds (p=0.018), closure by DOL4 showed a trend toward earlier feeding (p=0.13). Conclusion: Earlier closure of gastroschisis after silo placement was associated with earlier feed initiation and shorter time to full feeds.

Keywords

• Closure timing
• Gastroschisis
• Enteral feeding
• Silo