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Mortality and neurodevelopmental outcomes in very low birth weight infants with esophageal atresia

Hiromu Miyake1,2, Reiji Nakano3, Seiichiro Yamamoto4

  • 1Department of Pediatric Surgery, Shizuoka Children's Hospital, 860 Urushiyama, Aoi-ku, Shizuoka, 4208660, Japan. herohero6tti@gmail.com.

Pediatric Surgery International
|November 17, 2023
PubMed

Insights

Very low birth weight infants with esophageal atresia face poor survival and neurodevelopmental outcomes. Lower birth weight and associated anomalies worsen prognosis for these vulnerable newborns.

Area of Science:

  • Neonatalogy
  • Pediatric Surgery
  • Developmental Pediatrics

Background:

  • Very low birth weight infants (VLBWIs) are considered high-risk for adverse outcomes when diagnosed with esophageal atresia (EA).
  • Detailed short- and long-term outcomes for VLBWIs with EA remain incompletely understood, necessitating further investigation.

Purpose of the Study:

  • To elucidate the short-term (survival discharge from NICU) and long-term (neurodevelopmental impairment at 3 years) outcomes in very low birth weight infants diagnosed with esophageal atresia.

Main Methods:

  • Clinical data from 103 VLBWIs with EA were analyzed from the Neonatal Research Network Japan database.
  • Exclusion criteria included chromosomal abnormalities. Short-term outcome was defined as survival discharge from the NICU.
  • Long-term outcome was assessed as neurodevelopmental impairment (NDI) at 3 years of age.

Main Results:

  • The overall survival discharge rate from the NICU was 68.0%.
  • Mortality risk significantly increased with reduced birth weight and the presence of associated anomalies.
  • Among survivors with available 3-year follow-up data (32.9%), 34.8% exhibited NDI, with risk increasing as birth weight decreased.

Conclusions:

  • Survival discharge rates for VLBWIs with EA remain suboptimal.
  • Infants with lower gestational age and associated anomalies experience significantly worse outcomes.
  • A considerable proportion of surviving VLBWIs with EA develop neurodevelopmental impairment, highlighting the need for specialized long-term care.
Abstract

Keywords:
Esophageal atresiaMortalityNeurodevelopmentTracheoesophageal fistulaVery low birth weight

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