Abstract:
BACKGROUND : The time from birth to the first paediatric surgical consultation of neonates with gastroschisis is a predictor
of mortality in developing countries. This is contrary to findings in the developed world. We set out to document this
relationship within our population.
METHODS : Neonates with gastroschisis who were transferred to Steve Biko Academic Hospital within the study period were
included. The association between mortality and demographic, clinical and biochemical variables was assessed. Significant
variables after univariate analysis were subjected to multivariate regression.
RESULTS : Sixty patients were included. The mortality rate was 65%. Mean transfer time and distance were 14.9 hours and
225km. Forty-eight per cent of the neonates were either dehydrated or in hypovolaemic shock clinically on arrival. Eight
neonates arrived hypothermic. It was shown through univariate analysis that female sex, appropriate weight for gestational
age, hydration status, gestation, transfer time, serum urea, base deficit and serum bicarbonate (HCO3) were significant
predictors of mortality. Only female sex, appropriate weight for gestational age and serum HC03 were shown to be significant
using ultivariate analysis.
CONCLUSION : Our high mortality rate was not due to lengthy transfer times. The poor clinical condition of the patients on
arrival at our hospital, which relates to deficiencies in the neonatal transfer system, had a direct impact on the survival of
neonates with gastroschisis.
