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Myth: gastroesophageal reflux is a pathological entity in the preterm infant

Christian F Poets1, Pablo E Brockmann

  • 1Department of Neonatology, University Children's Hospital, Tübingen, Germany. christian-f.poets@med.uni-tuebingen.de

Seminars in Fetal & Neonatal Medicine
|June 14, 2011
PubMed

Insights

Gastroesophageal reflux (GER) in preterm infants is common but rarely causes serious issues like apnea or failure to thrive. Current evidence does not support widespread anti-reflux medication use for these symptoms in this population.

Area of Science:

  • Neonatal Medicine
  • Pediatric Gastroenterology
  • Respiratory Medicine

Background:

  • Gastroesophageal reflux (GER) is frequently suspected in preterm infants, often leading to extensive investigations and treatments.
  • Concerns exist regarding potential complications of GER, including apnea, failure to thrive, and respiratory issues.

Purpose of the Study:

  • To critically review the existing evidence for and against a causal association between GER and its purported consequences in preterm infants.
  • To evaluate the necessity and efficacy of anti-reflux therapies in this vulnerable population.

Main Methods:

  • Systematic review of current scientific literature.
  • Analysis of studies investigating the relationship between GER and apnea, failure to thrive, wheezing, and respiratory diseases in preterm infants.
  • Assessment of diagnostic methodologies for GER and their limitations.

Main Results:

  • Lack of unequivocal evidence supporting a causal link between GER and apnea, despite physiological plausibility.
  • Most studies on preterm infants with failure to thrive have not demonstrated an association with GER.
  • Limited evidence supports a causal relationship between GER and respiratory problems in preterm infants.

Conclusions:

  • Gastroesophageal reflux (GER) is rarely associated with serious consequences in preterm infants.
  • The current evidence does not justify the widespread use of anti-reflux medications for symptoms like apnea or respiratory issues in this age group.
  • Improved methods are needed to identify preterm infants genuinely at risk for severe GER complications.

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