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Cincinnati Regional Incidence, Morbidity, and Mortality of Neonatal Foregut Defects and High Coincidence with Cardiovascular Malformations

Alan P Kenny, Meredith Tabangin, Eric Hall, Koryse Woodrooffe, Wendy Lai, Jareen Meinzen-Derr, Robert J Hopkin, and James MGreenberg

 The first trimester fetal foregut generates organs from larynx to ligament of Treitz. The incidence and clinical impact of many of the 29 congenital malformations arising from the foregut organs remain under characterized. We performed a retrospective chart review on patients from a geographically defined area born between 2006 and 2008 admitted to Cincinnati Children’s Hospital Neonatal Intensive Care Unit with diagnoses consistent with one or more congenital foregut malformations.

We found foregut malformations occurred in 1 in 801 births and determined the incidence for each individual foregut malformation, including some that have not previously been reported. We report a high rate of multiple congenital foregut malformations within an individual with coincidence of foregut malformations of 51.5%, and a high association with cardiovascular malformations (40%). Hospital stay was prolonged (32 days versus 5days). Need for assisted feeding (51%) and respiratory support (27%) at discharge were higher when compared to control patients (12 and 6%, respectively). Mortality was 7% in patients with foregut malformations. These data provide needed quantitation of the incidence, morbidity, and mortality related to congenital foregut defects present in inpatient neonates. The coincidence of foregut malformations with cardiovascular malformations underscores the need for further research into their coordinated embryologic formation to aid their prevention and treatment.