Outcomes of multi-gestational pregnancies affected by esophageal atresia - tracheoesophageal fistula

Corey Forster; Paul Zamiara; Eveline Lapidus-Krol; Monping Chiang; Vikki Scaini; Beth Haliburton; Aideen M Moore; Margaret A Marcon; Priscilla P L Chiu

doi:10.1016/j.jpedsurg.2019.04.026

Outcomes of multi-gestational pregnancies affected by esophageal atresia - tracheoesophageal fistula

J Pediatr Surg. 2019 Oct;54(10):2080-2083. doi: 10.1016/j.jpedsurg.2019.04.026. Epub 2019 May 6.

Authors

Corey Forster¹, Paul Zamiara², Eveline Lapidus-Krol², Monping Chiang², Vikki Scaini³, Beth Haliburton², Aideen M Moore⁴, Margaret A Marcon³, Priscilla P L Chiu⁵

Affiliations

¹ Division of General and Thoracic Surgery, The Hospital for Sick Children, Department of Surgery, University of Toronto, Toronto, Ontario, Canada; Division of Gastroenterology, Hepatology and Nutrition, The Hospital for Sick Children, Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada.
² Division of General and Thoracic Surgery, The Hospital for Sick Children, Department of Surgery, University of Toronto, Toronto, Ontario, Canada.
³ Division of Gastroenterology, Hepatology and Nutrition, The Hospital for Sick Children, Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada.
⁴ Division of Neonatology, The Hospital for Sick Children, Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada.
⁵ Division of General and Thoracic Surgery, The Hospital for Sick Children, Department of Surgery, University of Toronto, Toronto, Ontario, Canada. Electronic address: [email protected].

PMID: 31103274
DOI: 10.1016/j.jpedsurg.2019.04.026

Abstract

Background: Contemporary outcomes of infants with esophageal atresia with or without tracheoesophageal fistula (EA/TEF) from multi-gestational pregnancies compared to those of singleton pregnancies have not been reported.

Methods: A single-center retrospective review of EA/TEF patients born from 1999 to 2013 was performed. Patient demographics, gestational age (GA), birth weight, associated anomalies, requirement for gastrostomy tube and mortality were reviewed.

Results: Singleton EA/TEF patients outnumbered those from multi-gestational pregnancies nearly 10:1 (214 vs 22 patients). EA/TEF patients from multi-gestational pregnancies were more likely to be premature (77% vs. 32%), have lower birth weight (mean 1766 g vs. 2695 g), have associated duodenal atresia (18% vs. 6%) and require gastrostomy tube (41% vs. 33%) for feeding challenges compared to EA/TEF singletons. Mortality was also significantly greater for multi-gestational EA/TEF patients compared to singleton EA/TEF patients (18% vs. 6%).

Conclusion: EA/TEF infants from multi-gestational pregnancies have greater clinical complexity and mortality than singleton EA/TEF patients. Parents of EA/TEF multi-gestational infants should be appropriately counseled and supported.

Keywords: Congenital anomalies; Esophageal atresia; Morbidity; Mortality; Singleton pregnancy; Twin pregnancy.

MeSH terms

Esophageal Atresia* / epidemiology
Esophageal Atresia* / mortality
Esophageal Atresia* / surgery
Female
Gestational Age
Humans
Infant, Newborn
Infant, Newborn, Diseases* / epidemiology
Infant, Newborn, Diseases* / mortality
Infant, Newborn, Diseases* / surgery
Pregnancy
Pregnancy, Multiple / statistics & numerical data*
Retrospective Studies
Tracheoesophageal Fistula* / epidemiology
Tracheoesophageal Fistula* / mortality
Tracheoesophageal Fistula* / surgery
Treatment Outcome

Supplementary concepts

Esophageal atresia with or without tracheoesophageal fistula