Long-Term Nutritional Status in Children Born With Esophageal Atresia

Area of Science:

• Pediatric Gastroenterology
• Nutritional Science
• Congenital Malformations

Background:

• Esophageal atresia (EA) is associated with early undernutrition and growth delays in affected children.
• Longitudinal nutritional status in EA patients requires further investigation.

Purpose of the Study:

• To assess the long-term nutritional status of children born with esophageal atresia (EA).
• To identify risk factors associated with undernutrition and stunting in EA patients up to 16 years of age.

Main Methods:

• A longitudinal study of 204 children with EA (91% with tracheoesophageal fistula) from birth to 16 years.
• Evaluation of undernutrition (BMI Z-score < -2 SD) and stunting (HFA Z-score < -2 SD).
• Analysis of risk factors using regression models for interval-censored data.

Main Results:

• Children with EA consistently showed lower mean BMI and height-for-age Z-scores compared to the normal population up to age 16.
• At 12 years, BMI Z-scores approached normal ranges, but height-for-age Z-scores remained significantly different.
• Cumulative incidence of wasting was 7% at 1 year, with 25% experiencing undernutrition at least once between ages 1 and 16.
• Significant risk factors for undernutrition included congenital heart malformation, prenatal EA diagnosis, and proton pump inhibitor (PPI) use.
• Significant risk factors for stunting included genetic anomalies, multiple pregnancies, gastrostomy, and PPI use after age 1.

Conclusions:

• Children with EA remain at high risk for undernutrition and stunting throughout childhood and adolescence.
• Despite medical advancements, proactive nutritional monitoring and early interventions are essential for high-risk EA populations.