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The incidence of gastroesophageal reflux in preterm infants
A J Marino1, E Assing, M T Carbone
1Medical Center at Princeton, Department of Pediatrics, NJ 08540, USA.
Insights
Gastroesophageal reflux (GER) is common in preterm infants, with 63% showing abnormal results. GER is strongly linked to obstructive apnea in premature infants, highlighting the importance of diagnosis.
Area of Science:
- Neonatology
- Pediatric Gastroenterology
- Respiratory Medicine
Background:
- Gastroesophageal reflux (GER) is a common condition in infants.
- Preterm infants may be at higher risk for GER and its complications.
- Apnea is a significant concern in preterm infants, and its association with GER requires further investigation.
Purpose of the Study:
- To determine the incidence of GER in a cohort of preterm infants before hospital discharge.
- To investigate the association between GER and apnea, including obstructive and central types, in this population.
- To evaluate the utility of pneumocardiograms (PCG) and esophageal pH studies in diagnosing GER and associated respiratory events.
Main Methods:
- Seventy-five preterm infants (birth weight 1117 +/- 242 gm, gestational age 30 +/- 3 weeks) were studied.
- Infants underwent a two-channel pneumocardiogram and a 1-hour esophageal pH study (Tuttle test) before discharge (37-38 weeks postconceptional age).
- Home monitoring was continued post-discharge until established criteria were met.
Main Results:
- The Tuttle test for GER was abnormal in 63% of the infants.
- Among infants with GER, 47% experienced obstructive apnea during reflux episodes.
- 81% of infants with GER had episodes of either obstructive or central apnea, with 68% showing abnormal PCG results.
Conclusions:
- Gastroesophageal reflux is highly prevalent in preterm infants nearing hospital discharge.
- A significant association exists between GER and both obstructive and central apnea in preterm infants.
- Early diagnosis of GER is crucial in premature infants due to its strong link with recurrent or obstructive apnea, potentially impacting respiratory stability.
Abstract:
We observed an increased incidence of gastroesophageal reflux (GER) in a group of preterm infants. Seventy-five infants (birth weight 1117 +/- 242 gm, gestational age 30 +/- 3 weeks) were tested within 1 week before hospital discharge (37 to 38 weeks postconceptional age). All of the infants had a two-channel pneumocardiogram and a 1-hour esophageal pH study (Tuttle test). Home monitors were used for all infants after hospital discharge and their use was maintained until standard discontinuation criteria were achieved. The Tuttle test was abnormal in 47 (63%) of the infants. Of the 47 infants with GER, 22 (47%) had evidence of obstructive apnea during the periods of reflux and 32 (68%) had an abnormal PCG result. Thirty-eight (81%) of the infants with GER had episodes of either obstructive or central apnea. The diagnosis of GER is important in premature infants because of the high association with recurrent or obstructive apnea.