Systemic inflammation during the neonatal period and BMI at 1 year in infants with gastroschisis: a retrospective cohort study.

Growth faltering is a concern for infants with gastroschisis, yet factors influencing long-term growth remain unclear. This study explores the relationship between systemic inflammation during the neonatal period and growth outcomes in the first year of life. It is a monocentric retrospective study over a 10-year period. Neonates with gastroschisis admitted to our NICU and followed in our outpatient clinic were included. Data collection included perinatal and neonatal variables, complications, surgical interventions, feeding milestones, septic events, and C-reactive protein (CRP) values during hospitalization. The primary outcome was a body mass index (BMI) z-score ≤  - 1 SD at 1 year. Of 69 infants, 15 (22%) had a BMI z-score ≤  - 1 SD at 1 year, with a median z-score of - 1.48 (IQR: - 1.66; - 1.16), compared to a median z-score of - 0.23 (IQR: - 0.50; 1.10) for the remaining 54 infants. A BMI z-score ≤  - 1 SD was significantly associated with the use of a silo but not with other surgical or birth characteristics. All measures of systemic inflammation during NICU stay, including the number of days with CRP > 5 mg/L or CRP > 50 mg/L, maximum CRP levels, and the number of peak CRP above 50 mg/L, were significantly associated with BMI z-score ≤  - 1 SD at 1 year. Adjusted analyses confirmed that the number of days with CRP > 5 mg/L and peak CRP levels above 50 mg/L remained significant. Conclusion: Persistent and/or severe systemic inflammation related to medical-surgical management and its complications during the neonatal period is associated with impaired growth in infants with gastroschisis.