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Risk Factors for Feeding and Swallowing Disorders in Very Low Birth Weight Infants in Their Second Year of Life
Nuša Slana1,2, Irena Hočevar-Boltežar3,4, Lilijana Kornhauser-Cerar5
1Department for (Re)Habilitation of Children, University Rehabilitation Institute Republic of Slovenia Soča, SI-1000 Ljubljana, Slovenia.
Insights
Feeding and swallowing disorders (FSD) affect over a quarter of very low birth weight infants post-discharge, but most resolve by age four. Shorter birth length is a key predictor of persistent FSD.
Area of Science:
- Neonatology
- Pediatric Gastroenterology
- Developmental Pediatrics
Background:
- Feeding and swallowing disorders (FSD) are a concern in preterm infants.
- Very low birth weight (VLBW) infants face unique challenges post-discharge.
Purpose of the Study:
- To determine the prevalence of FSD in VLBW infants up to two years post-discharge.
- To identify risk factors and consequences of FSD in this population.
Main Methods:
- A cohort of 117 VLBW infants born between 2013-2015 was studied.
- Data collected via medical records and parental questionnaires post-discharge.
Main Results:
- FSD was present in 27.4% of infants at discharge, decreasing to 4.3% by age four.
- Significant risk factors included: gestational age <28 weeks, birth weight ≤1000g, birth length <33cm, and late oral feeding start.
- Birth length <33cm was the strongest predictor (OR 6.5) of persistent FSD.
Conclusions:
- FSD is common in VLBW infants after hospital discharge but often transient.
- Early identification of risk factors like short birth length is crucial for intervention.
- Persistent FSD may impact long-term growth and development.
Abstract:
Background and Objectives: This study aimed to identify the prevalence of feeding and swallowing disorders (FSD) in very low birth weight (VLBW, 1500 g or less) infants in the first two years after discharge from the maternity hospital, their possible risk factors, and the consequences of them. Materials and Methods: A total of 117 preterm children with VLBW born between 2013 and 2015 were included. The data concerning possible FSD after discharge from the hospital were obtained through accessible medical documentation for the child and a short parental questionnaire. Results: FSD was reported in 32 (27.4%) infants following discharge from the hospital but in only five children (4.3%) at a mean age of four years. Four variables (birth gestational age less than 28 weeks, birth weight equal to or less than 1000 g, birth length below 33 cm, and start of oral feeding after the 34th gestational week) were identified as risk factors for FSD after discharge. However, only birth length remained a significant predictor after being included in a binary logistic regression model (p = 0.000). Abnormal oral sensitivity and a decrease in weight to under the 10th percentile were significantly more common in the FSD group at follow-up visits at the age of about 2 years. Conclusions: FSD was still present in more than one-quarter of VLBW infants after discharge from the maternity hospital but mostly disappeared within four years. A birth gestational age under 28 weeks, weight up to 1000 g, the late beginning of per oral feeding, and a birth length below 33 cm were determined to be significant predictive factors for FSD. Having a birth length below 33 cm was associated with an almost 6.5-fold increase in the odds of having persistent FSD after discharge from the hospital. FSD in the first years of life may have an impact on the child's further growth and development.
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