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Published on: August 25, 2014
Screening for functional gastrointestinal disorders in preterm infants up to 12 months of corrected age: a
Yusuf Aydemir1, Ozge Aydemir2, Meltem Dinleyici3
1Faculty of Medicine Department of Pediatrics, Division of Gastroenterology and Hepatology, Eskisehir Osmangazi University, Meselik, 26040, Eskisehir, Turkey. dryusufaydemir@yahoo.com.
Insights
Preterm infants show higher rates of functional gastrointestinal disorders (FGIDs) like colic and constipation compared to full-term infants. Exclusive breastfeeding in the first six months reduces infantile colic incidence in preterm babies.
Area of Science:
- Pediatrics
- Gastroenterology
- Neonatology
Background:
- Functional gastrointestinal disorders (FGIDs) are common in infancy, yet data on preterm infants is limited.
- FGIDs present with chronic or recurrent symptoms unexplained by structural or biochemical abnormalities and can be age-dependent.
Purpose of the Study:
- To compare the frequency of FGIDs between preterm and term infants.
- To investigate associations between neonatal characteristics and FGID development in preterm infants.
Main Methods:
- A multicenter prospective cohort study involving 134 preterm and 104 term infants.
- Infants were assessed for FGIDs using Rome IV criteria at multiple time points up to 12 months corrected age.
- Preterm infants received an additional follow-up at 12 months corrected age.
Main Results:
- Preterm infants exhibited higher incidences of infantile colic, rumination syndrome, functional constipation, and infant dyschezia.
- Exclusive breastfeeding for the first six months was associated with a lower incidence of infantile colic in preterm infants (18.8% vs 52.1%).
- FGID symptoms, particularly infantile colic and regurgitation, appeared later in preterm infants (median 2 months) compared to term infants (median 1 month).
Conclusions:
- Preterm infants have a significantly higher prevalence of FGIDs than term infants.
- Screening for FGIDs is recommended for preterm infants, especially those with gastrointestinal complaints.
- Maturational differences may influence the timing of FGID onset in preterm infants, and exclusive breastfeeding is protective against infantile colic.
Abstract:
Functional gastrointestinal disorders (FGIDs) are characterized by a variety of symptoms that are frequently age-dependent, chronic, or recurrent and are not explained by structural or biochemical abnormalities. There are studies in the literature reporting different results regarding the relationship between prematurity and FGIDs. The main objective of this study was to compare the frequency of FGIDs between preterm and term infants. The secondary objective was to evaluate whether there was any association between neonatal characteristics and development of FGIDs. A multicenter prospective cohort study that included preterm infants born before 37 weeks of gestation and healthy term infants was carried out. At 1, 2, 4, 6, 9, and 12 months of age, infants were assessed for the presence of FGIDs using the Rome IV criteria. In preterm infants, an additional follow-up visit was made at 12 months corrected age. 134 preterm and 104 term infants were enrolled in the study. Infantile colic, rumination syndrome, functional constipation, and infant dyschezia were more common in preterm infants. Incidence of other FGIDs (infant regurgitation, functional diarrhea and cyclic vomiting syndrome) were similar among preterm and term infants. Preterm infants who are exclusively breastfeed in the first 6 months of life have a lower incidence of infantile colic (18.8% vs 52.1%, p = 0.025). In terms of chronological age, FGIDs symptoms started later in preterm infants; this difference was statistically significant for infantile colic and regurgitation (median age 2 months vs 1 month, p < 0.001). Conclusions: Preterm infants have a higher prevalence of FGIDs compared with term controls. Therefore, especially if they have gastrointestinal complaints, they should be screened for FGIDs. Possibly due to maturational differences, the time of occurrence of FGIDs may differ in preterm infants. Infantile colic incidence decreases with exclusive breastfeeding. What is Known: • The functional gastrointestinal disorders are a very common in infancy. • Data on preterm infants with FGIDs are currently very limited. What is New: • Preterm infants have a higher incidence of infantile colic, rumination syndrome, functional constipation and infant dyschezia when compared to term infants. • Preterm infants who are exclusively breastfed during the first 6 months of life experience a lower incidence of infantile colic.
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