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Longitudinal evaluation of growth in oesophageal atresia patients up to 12 years
Floor W T Vergouwe1,2, Marjolein Spoel1, Nicole W G van Beelen1
1Department of Intensive Care and Pediatric Surgery, Erasmus MC University Medical Center-Sophia Children's Hospital, Rotterdam, The Netherlands.
Insights
Children with oesophageal atresia (OA) show reduced growth initially but normalize by age 12. Early nutritional support is crucial for those with low birth weight or after fundoplication surgery.
Area of Science:
- Pediatric Surgery
- Growth and Development
- Congenital Abnormalities
Background:
- Oesophageal atresia (OA) repair is associated with growth deficits.
- Long-term growth patterns post-OA repair require further investigation.
Purpose of the Study:
- To evaluate long-term growth outcomes in children following oesophageal atresia repair.
- To identify factors influencing growth in this patient population.
Main Methods:
- A longitudinal cohort study included 126 children with OA born between 1999-2013.
- Growth parameters (height-for-age, weight-for-height) were assessed up to 12 years using SD scores.
- Linear mixed models analyzed growth trends and influencing factors, excluding children with genetic growth disorders.
Main Results:
- Height-for-age SD scores were below normal up to 8 years, improving to -0.20 by 12 years.
- Weight-for-height SD scores normalized by age 5 years, reaching 0.03 at 12 years.
- Low birth weight and fundoplication surgery were associated with poorer growth outcomes.
Conclusions:
- Growth in OA patients normalizes by age 12, though initial deficits are observed.
- Further studies are needed to confirm sustained growth into adolescence.
- Nutritional assessment and intervention are recommended for high-risk OA patients.
Objective:
Previous studies reported diminished growth after oesophageal atresia (OA) repair. We evaluated long-term follow-up data on growth.
Methods:
Longitudinal cohort study up to 12 years. Patients with OA, born 1999-2013, who participated in a longitudinal follow-up programme were included. Children with genetic syndromes associated with growth disorders were excluded. SD scores (SDS) for height-for-age (HFA), weight-for-height (WFH) and distance-to-target-height were calculated for routine visits (0.5/1/2/5/8/12 years). Linear mixed models were used to estimate SDS until 12 years of age and to evaluate explanatory factors for growth.
Results:
We included 126/155 children (32% prematurely born, 20% small for gestational age), 32 reached the age of 12 years. Fundoplication surgery was performed in 24%. SDS-HFA was below normal up to 8 years but improved over these years (mean (SE) -0.48 (0.09), -0.31 (0.09) and -0.20 (0.13) at 0.5, 8 and 12 years). Scores improved after correction for target height (mean (SE) -0.29 (0.10), -0.17 (0.09) and -0.10 (0.14) at 0.5, 8 and 12 years). SDS-WFH was below normal from age 1-5 years (mean (SE) -0.53 (0.09), -0.24 (0.09) and 0.03 (0.14) at 1, 5 and 12 years). Low birth weight and fundoplication surgery were negatively associated with growth.
Conclusions:
The growth of patients with OA was below the reference norm during the first years of life, but normalised at 12 years. Large longitudinal cohort studies should evaluate if normal growth persists into adolescence. Early nutritional assessment with timely dietary intervention should be considered especially in those with low birth weight or following fundoplication surgery.
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