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Need for Gastrostomy Tube in Periviable Infants

Erica E ElSeed Peterson1, Jared T Roeckner2, Taylor W Deall1

  • 1Division of Neonatology, Department of Pediatrics, University of South Florida, Morsani College of Medicine, Tampa, Florida.

American Journal of Perinatology
|March 21, 2024
PubMed

Insights

Black race, singleton gestation, and bronchopulmonary dysplasia (BPD) increase the need for gastrostomy tubes in periviable infants. These findings highlight disparities and the need for further research into feeding outcomes for preterm infants.

Area of Science:

  • Neonatalogy
  • Perinatal Medicine
  • Pediatric Gastroenterology

Background:

  • Periviable infants (22-25 weeks' gestation) face significant challenges, including feeding difficulties.
  • Gastrostomy tube (g-tube) placement is a common intervention for nutritional support in this population.
  • Understanding factors associated with g-tube need is crucial for optimizing care and outcomes.

Purpose of the Study:

  • To identify clinical and demographic factors associated with gastrostomy tube (g-tube) placement in periviable infants.
  • To investigate the relationship between maternal race, gestational factors, and neonatal morbidities with g-tube requirements.

Main Methods:

  • A single-center retrospective cohort study was conducted.
  • Included live-born infants between 22 and 25 weeks' gestation.
  • Excluded infants not actively resuscitated or with congenital anomalies.

Main Results:

  • Of 243 infants, 158 survived to discharge, with 35 requiring g-tube placement.
  • Maternal Black race (OR=2.88), singleton gestation (OR=3.99), and bronchopulmonary dysplasia (BPD) were significantly associated with g-tube need.
  • Severe intraventricular hemorrhage was linked to increased mortality or g-tube placement.

Conclusions:

  • A substantial proportion of surviving periviable infants require g-tube placement.
  • Maternal Black race, singleton gestation, and BPD are key risk factors for g-tube need in this cohort.
  • Further research is warranted to address racial disparities and improve oral feeding success in preterm infants.
Abstract

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