Analysis of clinical characteristics and comparison of survival of inborn versus outborn cases of esophageal atresia with tracheo-esophageal fistula

Md Mokarram Ali; Yogender Singh Kadian; Jagjit Singh Dalal

doi:10.47338/jns.v14.1402

Authors

Md Mokarram Ali MS, MCh, Associate Professor, Department of Paediatric Surgery, Pt B D S PGIMS, Rohtak, Haryana
Yogender Singh Kadian Department of Paediatric Surgery, Pt B D S PGIMS, Rohtak, Haryana
Jagjit Singh Dalal Department of Neonatology, Pt B D S PGIMS, Rohtak, Haryana

DOI:

https://doi.org/10.47338/jns.v14.1402

Keywords:

Congenital anomalies, Esophageal atresia, Prematurity, Survival

Abstract

Background: Many factors influence the survival of newborns with esophageal atresia and tracheoesophageal fistula, including birth weight, maturity at birth, and associated congenital anomalies. However, the impact of the place of delivery on the survival of esophageal atresia cases has rarely been explored. This study aims to compare the survival rates of newborns with esophageal atresia and tracheoesophageal fistula (EA/TEF) born at our tertiary care center (inborn) with those born elsewhere and referred to our center for management (outborn).
Methods: This retrospective observational study was conducted from June 2021 to December 2023 at a tertiary care center in North India. A total of 46 cases of EA/TEF were included. These cases were divided into two groups: outborn and inborn. Outborn cases comprised those delivered at other hospitals and admitted through the pediatric emergency department of our institute. Inborn cases were delivered at our institute and admitted to the neonatal ICU managed by neonatologists.
Results: Among the 46 cases, 17 (36.96%) were inborn, and 29 (63.04%) were outborn. The average birth weight in the inborn group was 1.74 ± 0.53 kg, compared to 2.22 ± 0.34 kg in the outborn group (p = 0.0006). Preterm births were more common in the inborn group than in the outborn group (p = 0.004). Associated VACTERL anomalies were present in 6 cases in each group, accounting for 35.29% of inborn cases, 20.69% of outborn cases, and 26.09% overall. The overall survival rate was 41.30%. Survival was higher in the inborn group (58.82%) compared to the outborn group (31.03%), though this difference was not statistically significant (p = 0.064).
Conclusion: The survival of newborns with esophageal atresia in developing nations depends on various factors beyond birth weight, maturity, and associated anomalies. The availability of pediatric surgical facilities and neonatology support at the place of delivery significantly impacts outcomes and warrants further detailed study.

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