Neonatal Outcomes of Intestinal Atresia – Impact of Prenatal Diagnosis

Abstract

Abstract Purpose Following surgical correction, infants with jejunal and ileal atresia (JIA) have a period of intestinal dysfunction whilst establishing enteral feeds. We aimed to identify factors associated with prolonged duration of parenteral nutrition (PN) or length of stay (LOS) to inform discussions with families. Methods Retrospective review of all cases with JIA (January 2000-April 2021). Key outcomes were duration of PN, LOS, additional procedures performed and mortality. Infants with underlyingcomorbidities were excluded (e.g. meconium complications of cystic fibrosis, gastroschisis). Data are median (IQR). Results Seventy-six infants were included. Median gestational age (GA) was 37 (34-38) weeks and birth weight 2.9kg (2.4-3.3). Antenatally diagnosed in 35 (46%), location of atresia was jejunal in 41 (54%). Median duration of PN was longer for antenatally diagnosed cases compared to those postnatally (12.5 vs 5 days; p=0.01), as was LOS (19.5 vs 13; p=0.02). Multivariate analysis demonstrates infants diagnosed antenatally spend an extra 11 days on PN compared to those found postnatally and stay for an additional 11 days regardless of site of atresia. Conclusions Infants with antenatal diagnosis of JIA take significantly longer to establish enteral feed and have longer LOS. These data inform pre- and postnatal parental counselling and help establish standards for future comparison.