Congenital heart defects in newborns with apparently isolated single gastrointestinal malformation: A retrospective study
Section snippets
Background
Congenital gastrointestinal system malformations/abdominal wall defects (GISM) may be found in 1.8 per 1000 live births [1], [2]. In the gastrointestinal tract we can observe a variety of congenital defects because of the interference of genetic/environmental factors on splanchnic mesoderm differentiation during blastogenesis or successive phases of the development of primitive gut tube, including elongation, herniation outside the abdominal cavity, rotation, fixation, and neuronal migration [3]
Materials and methods
A retrospective chart review in a Neonatal Intensive Care Unit (NICU) with reference Centre for genetics and paediatric surgery was performed. All newborns who required surgery for GISM between 2009 and 2014 were recruited. GISM were divided based on International Classification of Diseases (ICD-10) into EA, pyloric atresia, duodenal atresia/stenosis, jejunal-ileal atresia/stenosis, colon atresia/stenosis, disorders of intestinal rotation and fixation, intestinal duplication, ARM, abdominal
Results
Isolated GISM was found in 65.8% (71/108) of evaluated newborns (group A). Male newborns resulted more affected by GISM than females (49 vs 22). Mean Apgar scores were 7 and 9 at 1 and 5 min, respectively. The mean gestational age was 37+ 1 weeks (range from 25+ 2 to 41+ 3 weeks), and mean birth weight was 2660 g (range from 700 to 4130 g). Eighteen newborns in group A versus two in group B were small for gestational age (25.4 vs 2.8%; p = 0.0001) (details in Table 1). Genetic counselling and karyotype
Discussion
The paucity of available data does not allow to distinguish adequately the genetic and/or environmental factors causing intestinal malformations [28]. The complex morphogenetic intestinal process requires the function of numerous regulatory and structural genes. For instance, the fibroblast growth factor 10 (Fgf10) and its receptor Fgfr2b play a role in the complex mesenchymal-epithelial cell interactions that result in embryologic morphogenesis of gastrointestinal tract [29]. The same factors
Conclusions
The association of CHD and GISM has been demonstrated by several studies in patients with multiple malformations of other systems. Instead, few studies have analyzed the incidence of CHD in apparently isolated GISM and the related complications. Our study has proven that a significant number of newborns with isolated GISM also present CHD. Furthermore, a pre-operatory functional heart disease will condition the postoperative outcome. Once identified the risk factors (central venosus catheter,
Conflict of interest
None
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