J Clin Gynecol Obstet

Journal of Clinical Gynecology and Obstetrics, ISSN 1927-1271 print, 1927-128X online, Open Access

Article copyright, the authors; Journal compilation copyright, J Clin Gynecol Obstet and Elmer Press Inc

Journal website https://www.jcgo.org

Original Article

Volume 12, Number 1, March 2023, pages 1-7

What Are the Top Benefits of a Prenatal Diagnosis of Fetal Esophageal or Intestinal Atresia?

Figure 1. Kaplan-Meier survival curves demonstrating the gestational age of delivery (a), the duration of hospital stay (b) and the duration of neonatal intensive care unit stay (c) data in the postnatal group and prenatal group.

**Table 1.** Maternal Clinical and Demographic Characteristics of the Study Population of Pregnant Women by Prenatal and Postnatal Diagnosis
Maternal characteristics	Prenatal (n = 29)	Postnatal (n = 22)	P
^aAverage distance between where the patient lives and the tertiary center used for a prenatal care. *P < 0.05. Data are given as mean ± standard deviation, median (interquartile range) or n (%). Comparisons between groups by Chi-square or Fisher’s exact tests for categorical variables and the Mann-Whitney U-test and unpaired t-tests for continuous variables. BMI: body mass index; NA: not applicable.
Age (years)	31 ± 5	29 ± 6	0.01*
BMI (kg/m²)	24 ± 5	24 ± 3	0.21
Obese (BMI ≥ 30 kg/m²)	4 (14%)	1 (5%)	0.65
Smoking during pregnancy
Non-smoker	15 (52%)	15 (68%)	0.16
Smoker < 10 cigarettes/day	5 (17%)	2 (9%)
Smoker ≥ 10 cigarettes/day	2 (6%)	1 (5%)
Obstetric history
Nulliparous	13 (45%)	12 (54%)	0.57
Presence of uterine scar	5 (17%)	1 (5%)	0.40
Diabetes
Pre-gestational diabetes mellitus	0 (0%)	1 (5%)	0.29
Gestational diabetes mellitus	3 (10%)	4 (18%)
Abnormal level II ultrasound	29 (100%)	3 (14%)	< 0.01*
Gestational age at time of level III ultrasound	24 (10)	NA	-
Distance between the patient’s residence and the tertiary centre (km)^a	83 (78)	86 (70)	0.90
Number of visits in a tertiary center	4 (3.5)	1.8 (1)	0.01*
Overall consultations in a tertiary center	6 (5)	0 (0)	0.01*
Total travel length (km)	661 (815)	164 (180)	0.01*

Table 1. Maternal Clinical and Demographic Characteristics of the Study Population of Pregnant Women by Prenatal and Postnatal Diagnosis

Maternal characteristics

Prenatal (n = 29)

Postnatal (n = 22)

^aAverage distance between where the patient lives and the tertiary center used for a prenatal care. *P < 0.05. Data are given as mean ± standard deviation, median (interquartile range) or n (%). Comparisons between groups by Chi-square or Fisher’s exact tests for categorical variables and the Mann-Whitney U-test and unpaired t-tests for continuous variables. BMI: body mass index; NA: not applicable.

Age (years)

31 ± 5

29 ± 6

0.01*

BMI (kg/m²)

24 ± 5

24 ± 3

0.21

Obese (BMI ≥ 30 kg/m²)

4 (14%)

1 (5%)

0.65

Smoking during pregnancy

Non-smoker

15 (52%)

15 (68%)

0.16

Smoker < 10 cigarettes/day

5 (17%)

2 (9%)

Smoker ≥ 10 cigarettes/day

2 (6%)

1 (5%)

Obstetric history

Nulliparous

13 (45%)

12 (54%)

0.57

Presence of uterine scar

5 (17%)

1 (5%)

0.40

Diabetes

Pre-gestational diabetes mellitus

0 (0%)

1 (5%)

0.29

Gestational diabetes mellitus

3 (10%)

4 (18%)

Abnormal level II ultrasound

29 (100%)

3 (14%)

< 0.01*

Gestational age at time of level III ultrasound

24 (10)

Distance between the patient’s residence and the tertiary centre (km)^a

83 (78)

86 (70)

0.90

Number of visits in a tertiary center

4 (3.5)

1.8 (1)

0.01*

Overall consultations in a tertiary center

6 (5)

0 (0)

0.01*

Total travel length (km)

661 (815)

164 (180)

0.01*

**Table 2.** Obstetric Outcomes of the Study Population of Fetuses by Prenatal and Postnatal Diagnosis
Obstetric outcomes	Prenatal (n = 29)	Postnatal (n = 22)	P
*P < 0.05. Data are given as mean ± standard deviation, median (interquartile range) or n (%). Comparisons between groups by Chi-square or Fisher’s exact tests for categorical variables and the Mann-Whitney U-test and unpaired t-tests for continuous variables. GA: gestational age; NA: not applicable.
Polyhydramnios	12 (41%)	5/11 (45%)	> 0.99
Hospitalization in high-risk maternity unit	7 (24%)	2 (9%)	0.27
Severe polyhydramnios	4 (14%)	0 (0%)	0.12
At high-risk of preterm birth	3 (10%)	1 (5%)	0.65
Premature rupture of membranes	3 (10%)	0 (0%)	0.26
Course of antenatal steroids	9 (31%)	NA	-
GA at delivery (weeks)	36 ± 2.5	38 ± 2.2	0.10
Delivery before 37 weeks	17 (59%)	7 (31%)	0.05*
Delivery before 34 weeks	7 (24%)	0 (0%)	0.01*
Induction of labor	12 (41%)	9 (41%)	0.77
Mode of delivery, indication
Vaginal	14 (48%)	10 (45%)	0.58
Operative vaginal	4 (14%)	5 (23%)	0.54
Elective cesarian delivery	7 (24%)	3 (14%)	0.77
Cesarian delivery for fetal indication	4 (14%)	4 (18%)

Table 2. Obstetric Outcomes of the Study Population of Fetuses by Prenatal and Postnatal Diagnosis

Obstetric outcomes

Prenatal (n = 29)

Postnatal (n = 22)

*P < 0.05. Data are given as mean ± standard deviation, median (interquartile range) or n (%). Comparisons between groups by Chi-square or Fisher’s exact tests for categorical variables and the Mann-Whitney U-test and unpaired t-tests for continuous variables. GA: gestational age; NA: not applicable.

Polyhydramnios

12 (41%)

5/11 (45%)

> 0.99

Hospitalization in high-risk maternity unit

7 (24%)

2 (9%)

0.27

Severe polyhydramnios

4 (14%)

0 (0%)

0.12

At high-risk of preterm birth

3 (10%)

1 (5%)

0.65

Premature rupture of membranes

3 (10%)

0 (0%)

0.26

Course of antenatal steroids

9 (31%)

GA at delivery (weeks)

36 ± 2.5

38 ± 2.2

0.10

Delivery before 37 weeks

17 (59%)

7 (31%)

0.05*

Delivery before 34 weeks

7 (24%)

0 (0%)

0.01*

Induction of labor

12 (41%)

9 (41%)

0.77

Mode of delivery, indication

Vaginal

14 (48%)

10 (45%)

0.58

Operative vaginal

4 (14%)

5 (23%)

0.54

Elective cesarian delivery

7 (24%)

3 (14%)

0.77

Cesarian delivery for fetal indication

4 (14%)

4 (18%)

**Table 3.** Univariable Regression Analysis in Prediction of Preterm Birth Before 37 Weeks
Variable	Crude OR (95% CI)	P value
*P < 0.05. BMI: body mass index; OR: odds ratio; CI: confidence interval.
Maternal characteristics
Maternal age (years)	1.04 (0.94 - 1.15)	0.49
Maternal BMI (kg/m²)	0.91 (0.80 - 1.05)	0.20
Smoking during pregnancy
Non-smoker (reference)	1.00	0.30
Smoker	0.55 (0.18 - 1.70)
Parous (reference)	1.00	0.66
Nulliparous	1.28 (0.42 - 3.93)
Pregnancy complication
Gestational diabetes	1.55 (0.42 - 5.77)	0.51
Polyhydramnios	1.53 (0.42 - 5.61)	0.52
Severe polyhydramnios	4.06 (0.39 - 42.49)	0.24
Type of atresia
Esophageal atresia	1.36 (0.45 - 4.16)	0.56
Duodenal atresia	1.53 (0.31 - 7.69)	0.60
Jejunoileal atresia	0.78 (0.24 - 2.57)	0.68
Colonic atresia	0.33 (0.03 - 3.45)	0.36
Associated anomalies	1.15 (0.38 - 3.53)	0.80
Prenatal diagnosis	3.12 (1.02 - 10.72)	0.046*
Total travel length (km)	1.00 (0.99 - 1.00)	0.58

Table 3. Univariable Regression Analysis in Prediction of Preterm Birth Before 37 Weeks

Variable

Crude OR (95% CI)

P value

*P < 0.05. BMI: body mass index; OR: odds ratio; CI: confidence interval.

Maternal characteristics

Maternal age (years)

1.04 (0.94 - 1.15)

0.49

Maternal BMI (kg/m²)

0.91 (0.80 - 1.05)

0.20

Smoking during pregnancy

Non-smoker (reference)

1.00

0.30

Smoker

0.55 (0.18 - 1.70)

Parous (reference)

1.00

0.66

Nulliparous

1.28 (0.42 - 3.93)

Pregnancy complication

Gestational diabetes

1.55 (0.42 - 5.77)

0.51

Polyhydramnios

1.53 (0.42 - 5.61)

0.52

Severe polyhydramnios

4.06 (0.39 - 42.49)

0.24

Type of atresia

Esophageal atresia

1.36 (0.45 - 4.16)

0.56

Duodenal atresia

1.53 (0.31 - 7.69)

0.60

Jejunoileal atresia

0.78 (0.24 - 2.57)

0.68

Colonic atresia

0.33 (0.03 - 3.45)

0.36

Associated anomalies

1.15 (0.38 - 3.53)

0.80

Prenatal diagnosis

3.12 (1.02 - 10.72)

0.046*

Total travel length (km)

1.00 (0.99 - 1.00)

0.58

**Table 4.** Neonatal Outcomes of the Study Population of Fetuses by Prenatal and Postnatal Diagnosis
Neonatal outcomes	Prenatal (n = 30)	Postnatal (n = 22)	P
^aMissing information *P < 0.05. Data are given as mean ± standard deviation, median (interquartile range) or n (%). Comparisons between groups by Chi-square or Fisher’s exact tests for categorical variables and the Mann-Whitney U-test and unpaired t-tests for continuous variables.
Sex
Male	18	13	> 0.99
Female	12	9
Birth weight (g)	2,633 ± 684	2,800 ± 486	0.35
Birth height (cm)	47.6 ± 2	46.8 ± 1.5	0.21
Head circumference at birth (cm)	35 ± 1.5	34 ± 0.8	0.04*
5-min Apgar score < 7	2 (7%)	0 (0%)	0.52
pH < 7.20	8 (27%)	2/10 (20%)^a	> 0.71
Mechanical ventilation	15 (52%)	10 (45%)	> 0.99
Phototherapy	5 (17%)	3 (14%)	> 0.99
Infection	19 (65%)	8 (36%)	0.09
Associated anomalies	13 (45%)	10 (45%)	> 0.99
VACTERL	2 (7%)	1 (5%)
CHARGE syndrome	1 (3%)	0 (0%)
Chromosomal anomalies	3 (10%)	0 (0%)
Type of atresia
Esophageal atresia	9 (31%)	15 (68%)	0.06*
Duodenal atresia	5 (17%)	2 (14%)	0.67
Jejunoileal atresia	14 (46%)	3 (14%)	0.02*
Colonic atresia	2 (7%)	2 (9%)	> 0.99
Age at surgery (days)	2 (2)	2 (2.5)	0.80
Cutaneous stoma	10 (34%)	4 (18%)	0.34
Second surgery	10 (34%)	5 (23%)	0.54
Parenteral nutrition (days)	7 (7)	7 (7)	0.64
Duration of hospital stay (days)	28 (45)	18 (12)	0.08
Duration of neonatal intensive care unit stay (days)	12 (41)	6 (4)	0.02*
Duration of neonatal reanimation stay (days)	10 (15)	10 (6)	0.86
Neonatal death	2 (7%)	1 (5%)	> 0.99

Table 4. Neonatal Outcomes of the Study Population of Fetuses by Prenatal and Postnatal Diagnosis

Neonatal outcomes

Prenatal (n = 30)

Postnatal (n = 22)

^aMissing information *P < 0.05. Data are given as mean ± standard deviation, median (interquartile range) or n (%). Comparisons between groups by Chi-square or Fisher’s exact tests for categorical variables and the Mann-Whitney U-test and unpaired t-tests for continuous variables.

Sex

Male

> 0.99

Female

Birth weight (g)

2,633 ± 684

2,800 ± 486

0.35

Birth height (cm)

47.6 ± 2

46.8 ± 1.5

0.21

Head circumference at birth (cm)

35 ± 1.5

34 ± 0.8

0.04*

5-min Apgar score < 7

2 (7%)

0 (0%)

0.52

pH < 7.20

8 (27%)

2/10 (20%)^a

> 0.71

Mechanical ventilation

15 (52%)

10 (45%)

> 0.99

Phototherapy

5 (17%)

3 (14%)

> 0.99

Infection

19 (65%)

8 (36%)

0.09

Associated anomalies

13 (45%)

10 (45%)

> 0.99

VACTERL

2 (7%)

1 (5%)

CHARGE syndrome

1 (3%)

0 (0%)

Chromosomal anomalies

3 (10%)

0 (0%)

Type of atresia

Esophageal atresia

9 (31%)

15 (68%)

0.06*

Duodenal atresia

5 (17%)

2 (14%)

0.67

Jejunoileal atresia

14 (46%)

3 (14%)

0.02*

Colonic atresia

2 (7%)

2 (9%)

> 0.99

Age at surgery (days)

2 (2)

2 (2.5)

0.80

Cutaneous stoma

10 (34%)

4 (18%)

0.34

Second surgery

10 (34%)

5 (23%)

0.54

Parenteral nutrition (days)

7 (7)

0.64

Duration of hospital stay (days)

28 (45)

18 (12)

0.08

Duration of neonatal intensive care unit stay (days)

12 (41)

6 (4)

0.02*

Duration of neonatal reanimation stay (days)

10 (15)

10 (6)

0.86

Neonatal death

2 (7%)

1 (5%)

> 0.99