Predictors of Mortality in Neonates with Congenital Anterior Abdominal Wall Defects: A Twelve-Year Review of Records in a Tertiary Health Centre

Background: Anterior abdominal wall defect is a spectrum of congenital malformations arising from defective fusion or development of the embryonic folds. Gastroschisis and omphalocele constitute the majority of cases. Methods: A retrospective study of newborns with anterior abdominal wall defects at our facility from February 2012 to June 2023. Results: A Total of 142 newborns presented with anterior abdominal wall defects. Females 74 and males 68, ratio of 0.9:1. Median age at presentation was 18.5 hours. Mean birth weight was 2.6 ± 0.6 kg, range of 1.1 kg - 4.2 kg. There were 120 (83.8%) newborns with omphalocele, 14 (9.9%) with gastroschisis, prune belly 3 (2.1%), bladder exstrophy, cloacal exstrophy, a set of conjoined twins and pentalogy of Cantrell 1 (0.7%) each. Of the 120 with omphalocele, 107 were omphalocele major, 13 omphalocele minor while 45 (37.5%) presented with ruptured membrane. Complication: sepsis (38, 26.7%). Length of hospital stay 0.2 days - 63 days, mean of 15 days. Mortality 62 (43.7%), treated and discharged home 80 (56.3%). Of the 62 mortalities, 45 (72.6%) occurred in week one. Case fatality rate: pentalogy of Cantrell 1(100%), Gastroschisis 13 (92.85%) and omphalocele major 44 (41.1%). Of the 44 mortalities with omphalocele major, 26 (51.1%) had ruptured membranes. Conclusion: Low birth weight and type of defect (ruptured omphalocele and gastroschisis) were significant predictors of mortality.