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Factors associated with postmenstrual age at full oral feeding in very preterm infants
Grégoire Brun1, Céline J Fischer Fumeaux2, Eric Giannoni2
1Emergency Care, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
Insights
Bronchopulmonary dysplasia and duration of respiratory support significantly delay full oral feeding in very preterm infants. These factors, along with patent ductus arteriosus, impact feeding milestones and hospital stay duration.
Area of Science:
- Neonatal Medicine
- Pediatric Gastroenterology
- Respiratory Medicine
Background:
- Very preterm infants often experience feeding difficulties.
- Achieving full oral feeding (FOF) is a critical milestone impacting infant health and hospital length of stay.
Purpose of the Study:
- To identify factors associated with the age of achieving FOF in very preterm infants.
- To understand predictors of delayed feeding in this vulnerable population.
Main Methods:
- Retrospective study of 122 infants born before 32 weeks gestation.
- Dichotomized infants by median age at FOF.
- Utilized univariable and multivariable linear regression analysis.
Main Results:
- Median age at FOF was 36 6/7 weeks postmenstrual age.
- Bronchopulmonary dysplasia, duration of non-invasive ventilation, oxygen therapy, and patent ductus arteriosus were associated with older age at FOF.
- Bronchopulmonary dysplasia was the strongest predictor of delayed FOF.
Conclusions:
- Lung disease severity (bronchopulmonary dysplasia) is a primary determinant of FOF age.
- Socioeconomic status and patent ductus arteriosus also influence feeding outcomes.
- Further research is needed for evidence-based care bundles to mitigate feeding and neurodevelopmental impairments.
Aim:
We aimed to identify variables associated with gestational age at full oral feeding in a cohort of very preterm infants.
Methods:
In this retrospective study, all infants born below 32 weeks of gestation and admitted to a level III neonatal unit in 2015 were included. We dichotomized our population of 122 infants through the median age at full oral feeding, and explored which variables were statistically different between the two groups. We then used linear regression analysis to study the association between variables known from the literature and variables we had identified and age at full oral feeding.
Results:
The median postnatal age at full oral feeding was 36 6/7weeks post menstrual age (Q1-Q3 35 6/7-392/7), and was associated with the duration of hospital of stay. In the univariable linear regression, the variables significantly associated with full oral feeding were gestational age, socioeconomic status, sepsis, patent ductus arteriosus, duration of supplementary oxygen, of non-invasive and invasive ventilation, and bronchopulmonary dysplasia. In the multivariable regression analysis, duration of non-invasive ventilation and oxygen therapy, bronchopulmonary dysplasia, and patent ductus arteriosus were associated with an older age at full oral feeding, with bronchopulmonary dysplasia the single most potent predictor.
Discussion:
Lung disease severity is a major determinant of age at full oral feeding and thus length of stay in this population. Other factors associated with FOF include socioeconomic status and patent ductus arteriosus, There is a need for research addressing evidence-based bundles of care for these infants at risk of long-lasting feeding and neurodevelopmental impairments.
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