The Some Predictive Factors for Survival of Newborns with Esophageal Atresia

Authors

1 Department of Neonatology, Bahrami children’s Hospital, Tehran University of Medical Science, Tehran, Iran.

2 Pediatric Gastroenterology and Hepatology Research Center, Department of Pediatric, Bahrami children’s Hospital, Tehran University of Medical Science, Tehran, Iran.

3 Department of Pediatric Intensive Care Unit, Bahrami Children’s Hospital, Tehran University of Medical Science, Tehran, Iran.

Abstract

Background
The esophageal atresia (EA) is the most common esophageal congenital anomaly. The aim of this study was to evaluate the predictive factors in the survival of newborns with esophageal atresia.
Materials and Methods
This was a descriptive-analytic cross-sectional study performed on newborns with esophageal atresia who were admitted at Bahrami children’s hospital, Tehran-Iran, during 7 years (2009-2015). The patient’s information was collected from their medical records and recorded in a checklist. The variables of the checklist included: age, sex, gestational age, birth weight, congenital anomalies, duration of mechanical ventilation, duration of hospitalization, respiratory distress syndrome (RDS), and age at surgery, complications, and cause of death. Then, the relationship between different variables was evaluated with mortality and morbidity and the factors that had the greatest impact on patients' prognosis were identified.
Results: The study included 95 neonates with EA. Fifty-three (55.8%) were male. The most common anomalies were cardiac (38.9%), renal (15.8%), and skeletal (9.5%). The most common postoperative complication was pneumothorax (31.6%), pneumonia (25%), and stenosis at the site of anastomosis (21.1%). In this study, 15 children died (mortality rate 15.7%), and the most common cause was sepsis. There was a significant relationship between birth weight and death, pneumothorax (P=0.008, and P=0.037, respectively). There was no significant relationship between gestational age and mortality (P>0.05). There was a significant relationship between major cardiac anomalies and duration of mechanical ventilation and mortality (P= 0.043, and P<0.001, respectively).
Conclusion
This study showed that neonates with esophageal atresia, low birth weight, major cardiac anomalies and the need for prolonged mechanical ventilation are poor prognosis predictor factors.

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