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Impact of Surgery for Neonatal Gastrointestinal Diseases on Weight and Fat Mass
Angela De Cunto1, Giulia Paviotti1, Laura Travan1
1Department of Perinatal Medicine, Institute for Maternal and Child Health - IRCCS Burlo Garofolo, Trieste, Italy.
Insights
Infants undergoing gastrointestinal surgery had reduced growth and lower fat mass compared to controls, even with parenteral nutrition. Monitoring body composition is key for optimizing growth in these vulnerable newborns.
Area of Science:
- Pediatric Surgery
- Neonatal Nutrition
- Body Composition Analysis
Background:
- Infants with gastrointestinal diseases often require surgical intervention.
- Postnatal growth and body composition are critical indicators of health in neonates.
Purpose of the Study:
- To compare growth, fat mass, and fat-free mass in infants after gastrointestinal surgery versus matched controls.
- To assess body composition at a similar postconceptional age (PCA).
Main Methods:
- Air-displacement plethysmography (PeaPod) was used for body composition measurements.
- 21 surgical infants were matched with 21 controls based on gestational age, birth weight, and sex.
- Measurements were taken at the same postconceptional age (PCA).
Main Results:
- Postsurgical infants were shorter, lighter, and had significantly lower fat mass percentage compared to controls at similar PCA.
- All but one surgical infant received parenteral nutrition (PN), for a mean duration of 40 days.
- PN-associated cholestasis occurred in 9 surgical infants and 1 control.
Conclusions:
- Neonates undergoing gastrointestinal surgery exhibit impaired growth and reduced fat mass.
- Parenteral nutrition, while necessary, did not fully compensate for growth deficits.
- Regular body composition assessment is recommended to optimize growth outcomes in surgical neonates.
Objective:
To compare growth, fat mass (FM), and fat-free mass in surgical infants vs matched controls at similar postconceptional age (PCA).
Study Design:
Anthropometric and body composition measurements by air-displacement plethysmography (PeaPod-Infant Body Composition System; LMI, Concord, California) were performed at the same PCA in 21 infants who received gastrointestinal surgery and in 21 controls matched for gestational age, birth weight, and sex.
Results:
Despite similar anthropometry at birth, postsurgical infants were shorter (50.4 [4.7] cm vs 53.2 [4.1] cm, P = .001), lighter (3516 [743] g vs 3946 [874] g, P < .001), and had lower FM content (%FM 14.8 [4.7]% vs 20.2 [5.8]%, P < .0001) than their peers at similar PCA (43 [4] weeks). All surgical infants but 1 (20/21) received parenteral nutrition (PN). Mean PN duration was 40 (30) days. Five infants in the control group received PN because of prematurity for 15 (9-30) days. Nine infants in the surgical group and 1 in the control group had PN-associated cholestasis.
Conclusions:
Neonates having surgery for gastrointestinal diseases were shorter, had lower weight, and lower FM content than their peers, despite receiving more PN. Body composition evaluation and monitoring may help optimize growth in these newborns.
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