Respiratory outcomes in the first ten years-of-life in children with
gastroschisis: a retrospective cohort study
Abstract
Background Little attention has been given to the long-term respiratory
outcomes of children with gastroschisis. The purpose of this study was
to determine if gastroschisis survivors have more respiratory illnesses
in their first 10 years-of-life compared to age-matched controls.
Methods We performed a retrospective cohort study of all gastroschisis
children born in Manitoba between 1991-2017. Gastroschisis cases were
identified from a clinical database, and a date-of-birth matched control
cohort was constructed from a population-based data repository.
International Classification of Disease codes were used to compare the
risk and frequency of respiratory diagnoses for children with
gastroschisis to date-of-birth matched controls from 0-5 years-of-age
and 5-10 years-of-age. Results The 0-5 years-of-age analysis included
117 gastroschisis cases and 1205 date-of-birth matched controls;
children with gastroschisis had a higher risk of asthma (RR=1.46,
95%CI:1.03,2.55, p=0.029), acute bronchitis/bronchiolitis (RR=1.61,
95%CI:1.27,2.03, p<0.001), pneumonia (RR=1.99,
95%CI:1.45,2.72, p<0.001), viral pneumonia (RR=5.15,
95%CI:1.79,14.81, p=0.007), and pneumonia due to unspecified organism
(RR=2.06, 95%CI:1.45,2.92, p<0.001). Gastroschisis children
0-5 years-of-age were also diagnosed more frequently with
bronchitis/bronchiolitis (RR=2.14, 95%CI:1.79,2.57, p<0.001)
and viral pneumonia (RR=8.10, 95%CI:3.79,17.31, p<0.001). The
5-10 years-of-age analysis included 73 cases and 738 controls; no
difference in the risk of respiratory illness was found for
gastroschisis cases and controls in this age group. However,
gastroschisis cases were more frequently diagnosed with bacterial
pneumonia (RR=3.03, 95%CI:1.67,5.51, p<0.001) and influenza
(RR=3.03, 95%CI:1.67,5.51, p<0.001). Conclusion Our study
shows that children with gastroschisis have an increased risk of asthma
and respiratory infections compared to children without gastroschisis,
especially in the first 5 years-of-life.