Introduction: The optimal timing of delivery for pregnancies complicated by foetal gastroschisis remains controversial. Therefore, the aim of this study is to find whether elective or expectant delivery is associated with improved neonatal outcome. Materials and Methods: MEDLINE and Embase databases were searched for studies up to 2021 that reported timing of delivery for foetal gastroschisis. A systematic review and meta-analysis were then performed in group 1: moderately preterm (Gestational age, [GA] 34-35 weeks) elective delivery versus expectant management after GA 34-35 weeks; and group 2: near-term (GA 36-37 weeks) elective delivery versus expectant management after GA 36-37 weeks. The following clinical outcomes were evaluated: length of stay (LOS), total parenteral nutrition (TPN) days, bowel morbidity (atresia, perforation, and volvulus), sepsis, time of first feeding, short gut syndrome and respirator days, and mortality. Results: Two randomised controlled trails (RCT)s and eight retrospective cohort studies were included, comprising of 629 participants. Moderately preterm elective delivery failed to improve clinical outcomes. However, near-term elective delivery significantly reduced bowel morbidity (7.4% vs 15.4%, RR=0.37; CI 0.18, 0.74; p=0.005; I2=0%) and TPN days (MD=-13.44 days; CI -26.68, -0.20; p=0.05; I2=45%) compared to expectant delivery. The mean LOS was 39.2 days after near-term delivery and 48.7 days in the expectant group (p=0.06). Conclusions: Based on the data analysed, near-term elective delivery (GA 36-37 weeks) appears to be the optimal timing for delivery of pregnancies complicated by foetal gastroschisis as it is associated with less bowel morbidity and shorter TPN days. However, more RCTs are necessary to better validate these findings.

简介：妊娠合并胎儿腹裂的最佳分娩时机仍存在争议。因此，本研究的目的是确定择期分娩或期待分娩是否与改善的新生儿结局相关。材料和方法：在 MEDLINE 和 Embase 数据库中搜索截至 2021 年的研究，这些研究报告了胎儿腹裂的分娩时间。然后对第 1 组进行了系统回顾和荟萃分析：中度早产（胎龄，[GA] 34-35 周）选择性分娩与 GA 34-35 周后的期待治疗；第 2 组：GA 36-37 周后的近期（GA 36-37 周）择期分娩与期待治疗。评估了以下临床结果：住院时间 (LOS)、全胃肠外营养 (TPN) 天数、肠道并发症（闭锁、穿孔和肠扭转）、脓毒症、首次喂养时间、短肠综合征和呼吸器天数以及死亡率。结果：纳入了两项随机对照试验 (RCT) 和八项回顾性队列研究，共 629 名参与者。适度早产择期分娩未能改善临床结果。然而，近期择期分娩显着降低了肠道发病率（7.4% 对 15.4%，RR=0.37；CI 0.18，0.74；p=0.005；I2=0%）和 TPN 天数（MD=-13.44 天；CI -26.68， -0.20；p=0.05；I2=45%）与预期分娩相比。近期分娩后平均 LOS 为 39.2 天，预期组为 48.7 天 (p=0.06)。结论：根据分析的数据，近期选择性分娩（GA 36-37 周）似乎是胎儿腹裂并发妊娠分娩的最佳时机，因为它与较少的肠道发病率和较短的 TPN 天数相关。然而，需要更多的随机对照试验来更好地验证这些发现。