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Predictive factors for fundoplication following esophageal atresia repair. BACKGROUND: One of the most frequent complications after repair of esophageal atresia (EA) is gastroesophageal reflux disease (GERD). Although GERD associated with EA is well known to often require anti-reflux surgery, the predicting factors remain unclear. We retrospectively analyzed EA in our institute. METHODS: Among 65 children with EA treated in our institute from 1995 to 2018, 45 with Gross C type of EA followed for over 1 year were enrolled in this study. The patients were divided into fundoplication and non-fundoplication groups and compared in terms of their clinical features. RESULTS: The fundoplication and non-fundoplication groups included 13 and 32 cases, respectively. On a univariate analysis, the gestational age, body weight, prenatal diagnosis, polyhydramnios, re-do surgery and gap length for esophagus differed significantly between these groups (p < 0.05). CONCLUSION: An early delivery, low body weight, and long gap are reportedly risk factors for fundoplication. However, the present study further showed that the prenatal diagnosis and polyhydramnios were also significant contributing factors. The presence of a prenatal diagnosis and polyhydramnios may induce premature delivery. Therefore, cases of polyhydramnios suspected of EA should be managed to prevent early delivery, and more explanation of the postnatal course after surgery is required especially for prenatal diagnosis cases.