Associated Congenital Anomalies in Gastrointestinal Tract Atresias: An Early Outcome Analysis from a Turkish Tertiary Center

A BSTRACT Background: Gastrointestinal (GI) tract atresias occur in approximately 1 in 2000 live births and frequently present with associated congenital anomalies. This study aimed to determine the frequency and spectrum of associated anomalies in neonates with GI atresias and provide screening recommendations. Materials and Methods: A retrospective analysis was conducted on 150 neonates with congenital GI atresia at a tertiary pediatric surgery referral center over 7 years. All patients underwent systematic screening, including echocardiography, abdominal ultrasonography, cranial ultrasonography, and radiographic evaluation. Demographics, atresia type, associated anomalies, and in-hospital outcomes were evaluated. Results: The cohort comprised esophageal atresia/tracheoesophageal fistula in 33.3%, anorectal malformations in 34%, duodenal atresia in 18%, jejunoileal atresia in 10%, colonic atresia in 2.7%, and pyloric atresia in 2%. Associated anomalies were present in 87.3% of patients. Cardiovascular anomalies were most common (57.3%), followed by genitourinary (50%), central nervous system (19.3%), and limb (12.7%) anomalies. Atrial septal defect was the most frequent cardiovascular finding. Overall, in-hospital mortality was 14%. Sepsis was the leading cause of death (33%). Prematurity and low birth weight were significant mortality predictors, while the presence of associated anomalies was not. VACTERL association (66% mortality) was identified as a high-risk subgroup. Conclusions: GI atresias are frequently associated with multisystem anomalies, particularly involving the cardiovascular and genitourinary systems. Systematic screening for associated anomalies is recommended in all neonates with GI atresia for comprehensive care planning. While anomalies are highly prevalent, prematurity and low birth weight remain the primary determinants of mortality.