Outcomes Of Neonates Born With Gastroschisis-three Year Single Centre Retrospective Cross-sectional Study In Blantyre, Malawi

INTRODUCTION Gastroschisis (GS) is a congenital abdominal wall defect with resultant bowel protrusion (1,2) with a mortality rate 60% (3,5,8). No outcome studies have been done after the introduction of a specialised paediatric surgical centre in 2017. This study aims to review the current state of affairs concerning gastroschisis related mortality. AIM To evaluate survival of neonates born with GS and determine factors associated with increased mortality in this vulnerable population. METHODOLOGY An analytical cross-sectional study was conducted using patient files of neonates born with GS that were treated at the Mercy James Centre in Blantyre, Malawi between January 2021- December 2023. Demographic and patient characteristics were recorded alongside survival. All neonates born with GS that were treated within the study period were included; those who died on arrival/enroute were excluded. Data was entered into REDCap database and statistical analysis was carried out via SPSS v25. KEY RESULTS Of 183 case files, 176 met the eligibility criteria and were included in the analysis. The study had a male to female ratio of 1:1.6. 70% of the patients had a birthweight between 1500 and 2499 grams. 80% of the neonates were referred from the districts, with Mangochi and Chikwawa being home to the largest number of GS cases. The survival rate was noted to be 54.5% putting mortality at 45.5%. CONCLUSION There is notable improvement in survival of neonates born with GS in this study. Of all the variables studied, higher birthweight was noted to have a positive influence on survival. A prospective study of a similar nature with a larger sample size and catchment area would be beneficial in providing more accurate results.