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Growth Failure Prevalence in Neonates with Gastroschisis : A Statewide Cohort Study
Katie M Strobel1, Tahmineh Romero2, Katelin Kramer3
1Division of Neonatology and Developmental Biology, Department of Pediatrics, University of California Los Angeles, Los Angeles, CA.
Insights
Growth failure is common in infants with gastroschisis. This study highlights the need for improved nutritional support to address weight and linear growth deficits in these hospitalized infants.
Area of Science:
- Pediatric Surgery
- Neonatology
- Clinical Nutrition
Background:
- Gastroschisis is a congenital abdominal wall defect requiring surgical repair.
- Infants with gastroschisis often experience significant challenges with growth and nutrition post-operatively.
- Multicenter studies are crucial for understanding outcomes in rare neonatal conditions.
Purpose of the Study:
- To assess the incidence and patterns of growth failure in hospitalized infants diagnosed with gastroschisis.
- To identify factors associated with growth failure in this vulnerable population.
- To inform clinical practice regarding nutritional management strategies.
Main Methods:
- A multicenter study was conducted within the University of California Fetal Consortium.
- Included neonates diagnosed with gastroschisis.
- Growth failure at discharge was defined as a decrease >0.8 in weight or length z-score from birth; regression analysis assessed z-score changes over time.
Main Results:
- Among 125 infants, 55% experienced weight or length growth failure at discharge.
- Weight and length z-scores significantly declined from birth to 30 days (P < .001).
- Lower gestational age was associated with increased risk of weight growth failure (OR 0.70 per week, P = .004).
Conclusions:
- Linear growth failure is a prevalent issue in infants with gastroschisis.
- The findings underscore the critical need for enhanced nutritional support and management protocols.
- Further research into optimizing nutritional interventions is warranted.
Objectives:
To perform a multicenter study to assess growth failure in hospitalized infants with gastroschisis.
Study Design:
This study included neonates with gastroschisis within sites in the University of California Fetal Consortium. The study's primary outcome was growth failure at hospital discharge, defined as a weight or length z score decrease >0.8 from birth. Regression analysis was performed to assess changes in z scores over time.
Results:
Among 125 infants with gastroschisis, the median gestational age was 37 weeks (IQR 35-37). Length of stay was 32 days (23-60); 55% developed weight or length growth failure at discharge (28% had weight growth failure, 42% had length growth failure, and 15% had both weight and length growth failure). Weight and length z scores at 14 days, 30 days, and discharge were less than birth (P < .01 for all). Weight and length z scores declined from birth to 30 days (-0.10 and -0.11 z score units/week, respectively, P < .001). Length growth failure at discharge was associated with weight and length z score changes over time (P < .05 for both). Lower gestational age was associated with weight growth failure (OR 0.70 for each gestational age week, 95% CI 0.55-0.89, P = .004).
Conclusions:
Growth failure, in particular linear growth failure, is common in infants with gastroschisis. These data suggest the need to improve nutritional management in these infants.
