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Short-term weight gain velocity in infants with congenital diaphragmatic hernia (CDH)

Jason Gien1, Karna Murthy2, Eugenia K Pallotto3

  • 1Children's Hospital Colorado and University of Colorado School of Medicine, Aurora, CO, United States.

Early Human Development
|February 9, 2017
PubMed

Insights

Infants with congenital diaphragmatic hernia (CDH) have variable weight gain velocity (WGV). Both very low and very high WGV are linked to increased NICU mortality, suggesting a need for targeted nutritional strategies.

Area of Science:

  • Neonatalogy
  • Pediatric Surgery
  • Nutritional Science

Background:

  • Optimizing post-natal growth is crucial for infants with congenital diaphragmatic hernia (CDH).
  • The hypothesis is that improved linear growth enhances survival by addressing pulmonary hypoplasia.
  • Limited data exist on growth patterns and their impact on survival in CDH infants.

Purpose of the Study:

  • To investigate the relationship between in-hospital weight gain velocity (WGV) and survival in infants with CDH.
  • To identify optimal WGV ranges associated with better outcomes in CDH patients.

Main Methods:

  • Utilized the Children's Hospitals Neonatal Database (CHND) for infants with CDH born at ≥34 weeks gestation (2010-2014).
  • Calculated Weight Gain Velocity (WGV) and stratified infants into quartiles (Q1, Q2-3, Q4).
  • Employed descriptive statistics and unadjusted Kaplan-Meier analyses to assess WGV's impact on mortality and discharge.

Main Results:

  • Median WGV was 4.6 g/kg/day in 630 eligible infants.
  • Infants in the lowest WGV quartile (Q1) had shorter hospital stays and less need for TPN and GER interventions.
  • Both the lowest (Q1) and highest (Q4) WGV quartiles were significantly associated with increased NICU mortality compared to the middle quartiles (Q2-3).

Conclusions:

  • Weight gain velocity varies significantly among infants with CDH.
  • Extremes in WGV (both very low and very high) are associated with adverse outcomes, including higher NICU mortality.
  • Developing nutritional strategies to achieve optimal growth is essential for improving survival in CDH infants.
Abstract

Keywords:
Congenital diaphragmatic herniaNICUNeonatal growthNeonatal nutritionNeonatologyPulmonary hypertensionPulmonary hypoplasiaRespiratory failure

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