Feeding and Growth Outcomes in Infants with Type C Esophageal Atresia Who Undergo Early Primary Repair
To describe growth and feeding outcomes in patients with type C esophageal atresia who underwent early primary repair and to identify predictors for poor growth. This single-center, retrospective, cohort study included all patients with type C esophageal atresia who underwent early primary repair fr...
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| Veröffentlicht in: | The Journal of pediatrics 2022-02, Vol.241, p.77-82.e1 |
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| container_title | The Journal of pediatrics |
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| creator | Harrington, Amanda W. Riebold, Jane Hernandez, Kayla Staffa, Steven J. Meisner, Jay W. Zurakowski, David Jennings, Russell Hamilton, Thomas Zendejas, Benjamin |
| description | To describe growth and feeding outcomes in patients with type C esophageal atresia who underwent early primary repair and to identify predictors for poor growth.
This single-center, retrospective, cohort study included all patients with type C esophageal atresia who underwent early primary repair from 2013 to 2019. Weight-for-age z score (WAZ) was calculated at birth, and every 6 months until 3 years postoperatively. Longitudinal median regression was used to evaluate WAZ over time. A multivariable logistic regression model explored predictors of growth outcomes.
Of 46 infants who met the inclusion criteria, 72% were term. The median age at repair was 1.5 days of life (IQR, 1-2 days of life) and the hospital length of stay was 20 days (IQR-14, 30 days). Two patients had esophageal leak (4.3%). The median WAZ at birth was below average (−0.72; IQR, −1.37 to −0.40), but improved to reach average by 3 years (−0.025; IQR, −0.85 to 0.97, P |
| doi_str_mv | 10.1016/j.jpeds.2021.10.012 |
| format | Article |
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This single-center, retrospective, cohort study included all patients with type C esophageal atresia who underwent early primary repair from 2013 to 2019. Weight-for-age z score (WAZ) was calculated at birth, and every 6 months until 3 years postoperatively. Longitudinal median regression was used to evaluate WAZ over time. A multivariable logistic regression model explored predictors of growth outcomes.
Of 46 infants who met the inclusion criteria, 72% were term. The median age at repair was 1.5 days of life (IQR, 1-2 days of life) and the hospital length of stay was 20 days (IQR-14, 30 days). Two patients had esophageal leak (4.3%). The median WAZ at birth was below average (−0.72; IQR, −1.37 to −0.40), but improved to reach average by 3 years (−0.025; IQR, −0.85 to 0.97, P < .001). At discharge, 72% of patients were receiving full oral nutrition, which improved to 95% by 3 years. The only independent predictor of poor growth at 1 year (WAZ < −1 [33%]) was WAZ at discharge (P = .02).
Infants with esophageal atresia who undergo early primary repair are capable of achieving standard growth curves by 3 years of age. However, poor discharge WAZ score was predictive of poor WAZ score at 1 year. Efforts to identify at-risk patients and institute targeted inpatient and outpatient nutrition interventions are needed to improve their growth trajectory.</description><identifier>ISSN: 0022-3476</identifier><identifier>EISSN: 1097-6833</identifier><identifier>DOI: 10.1016/j.jpeds.2021.10.012</identifier><identifier>PMID: 34687688</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Child Development ; Child, Preschool ; Cohort Studies ; esophageal atresia ; Esophageal Atresia - surgery ; Female ; growth ; Humans ; Infant ; Infant, Newborn ; Male ; Nutritional Status ; Retrospective Studies</subject><ispartof>The Journal of pediatrics, 2022-02, Vol.241, p.77-82.e1</ispartof><rights>2021 Elsevier Inc.</rights><rights>Copyright © 2021 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c359t-75e1413c51c0d8507706d1fbf92e2d9b6a81ea7958e12a2464586a90eff418653</citedby><cites>FETCH-LOGICAL-c359t-75e1413c51c0d8507706d1fbf92e2d9b6a81ea7958e12a2464586a90eff418653</cites><orcidid>0000-0002-7588-7596 ; 0000-0002-8311-9255 ; 0000-0003-3610-6942 ; 0000-0002-2450-0988</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0022347621009781$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34687688$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Harrington, Amanda W.</creatorcontrib><creatorcontrib>Riebold, Jane</creatorcontrib><creatorcontrib>Hernandez, Kayla</creatorcontrib><creatorcontrib>Staffa, Steven J.</creatorcontrib><creatorcontrib>Meisner, Jay W.</creatorcontrib><creatorcontrib>Zurakowski, David</creatorcontrib><creatorcontrib>Jennings, Russell</creatorcontrib><creatorcontrib>Hamilton, Thomas</creatorcontrib><creatorcontrib>Zendejas, Benjamin</creatorcontrib><title>Feeding and Growth Outcomes in Infants with Type C Esophageal Atresia Who Undergo Early Primary Repair</title><title>The Journal of pediatrics</title><addtitle>J Pediatr</addtitle><description>To describe growth and feeding outcomes in patients with type C esophageal atresia who underwent early primary repair and to identify predictors for poor growth.
This single-center, retrospective, cohort study included all patients with type C esophageal atresia who underwent early primary repair from 2013 to 2019. Weight-for-age z score (WAZ) was calculated at birth, and every 6 months until 3 years postoperatively. Longitudinal median regression was used to evaluate WAZ over time. A multivariable logistic regression model explored predictors of growth outcomes.
Of 46 infants who met the inclusion criteria, 72% were term. The median age at repair was 1.5 days of life (IQR, 1-2 days of life) and the hospital length of stay was 20 days (IQR-14, 30 days). Two patients had esophageal leak (4.3%). The median WAZ at birth was below average (−0.72; IQR, −1.37 to −0.40), but improved to reach average by 3 years (−0.025; IQR, −0.85 to 0.97, P < .001). At discharge, 72% of patients were receiving full oral nutrition, which improved to 95% by 3 years. The only independent predictor of poor growth at 1 year (WAZ < −1 [33%]) was WAZ at discharge (P = .02).
Infants with esophageal atresia who undergo early primary repair are capable of achieving standard growth curves by 3 years of age. However, poor discharge WAZ score was predictive of poor WAZ score at 1 year. Efforts to identify at-risk patients and institute targeted inpatient and outpatient nutrition interventions are needed to improve their growth trajectory.</description><subject>Child Development</subject><subject>Child, Preschool</subject><subject>Cohort Studies</subject><subject>esophageal atresia</subject><subject>Esophageal Atresia - surgery</subject><subject>Female</subject><subject>growth</subject><subject>Humans</subject><subject>Infant</subject><subject>Infant, Newborn</subject><subject>Male</subject><subject>Nutritional Status</subject><subject>Retrospective Studies</subject><issn>0022-3476</issn><issn>1097-6833</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kE9PGzEQxa2KqqTQT1AJ-chl07G99noPHFAUKBISVQXiaDn2bOJos17sDVG-PRsCPfY00pv35s-PkJ8MpgyY-rWernv0ecqBs1GZAuNfyIRBXRVKC3FCJgCcF6Ks1Cn5nvMaAOoS4Bs5FaXSldJ6QpobRB-6JbWdp7cp7oYVfdgOLm4w09DRu66x3ZDpLoyNx32PdEbnOfYru0Tb0ushYQ6WPq8ifeo8pmWkc5vaPf2TwsamPf2LvQ3pnHxtbJvxx0c9I08388fZ7-L-4fZudn1fOCHroagkspIJJ5kDryVUFSjPmkVTc-S-XiirGdqqlhoZt7xUpdTK1oBNUzKtpDgjl8e5fYovW8yD2YTssG1th3GbDZdaCgU18NEqjlaXYs4JG9MfTzYMzAGwWZt3wOYA-CCOgMfUxceC7WKD_l_mk-houDoacHzzNWAy2QXs3Eg5oRuMj-G_C94A3seMOg</recordid><startdate>202202</startdate><enddate>202202</enddate><creator>Harrington, Amanda W.</creator><creator>Riebold, Jane</creator><creator>Hernandez, Kayla</creator><creator>Staffa, Steven J.</creator><creator>Meisner, Jay W.</creator><creator>Zurakowski, David</creator><creator>Jennings, Russell</creator><creator>Hamilton, Thomas</creator><creator>Zendejas, Benjamin</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-7588-7596</orcidid><orcidid>https://orcid.org/0000-0002-8311-9255</orcidid><orcidid>https://orcid.org/0000-0003-3610-6942</orcidid><orcidid>https://orcid.org/0000-0002-2450-0988</orcidid></search><sort><creationdate>202202</creationdate><title>Feeding and Growth Outcomes in Infants with Type C Esophageal Atresia Who Undergo Early Primary Repair</title><author>Harrington, Amanda W. ; Riebold, Jane ; Hernandez, Kayla ; Staffa, Steven J. ; Meisner, Jay W. ; Zurakowski, David ; Jennings, Russell ; Hamilton, Thomas ; Zendejas, Benjamin</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c359t-75e1413c51c0d8507706d1fbf92e2d9b6a81ea7958e12a2464586a90eff418653</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Child Development</topic><topic>Child, Preschool</topic><topic>Cohort Studies</topic><topic>esophageal atresia</topic><topic>Esophageal Atresia - surgery</topic><topic>Female</topic><topic>growth</topic><topic>Humans</topic><topic>Infant</topic><topic>Infant, Newborn</topic><topic>Male</topic><topic>Nutritional Status</topic><topic>Retrospective Studies</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Harrington, Amanda W.</creatorcontrib><creatorcontrib>Riebold, Jane</creatorcontrib><creatorcontrib>Hernandez, Kayla</creatorcontrib><creatorcontrib>Staffa, Steven J.</creatorcontrib><creatorcontrib>Meisner, Jay W.</creatorcontrib><creatorcontrib>Zurakowski, David</creatorcontrib><creatorcontrib>Jennings, Russell</creatorcontrib><creatorcontrib>Hamilton, Thomas</creatorcontrib><creatorcontrib>Zendejas, Benjamin</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The Journal of pediatrics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Harrington, Amanda W.</au><au>Riebold, Jane</au><au>Hernandez, Kayla</au><au>Staffa, Steven J.</au><au>Meisner, Jay W.</au><au>Zurakowski, David</au><au>Jennings, Russell</au><au>Hamilton, Thomas</au><au>Zendejas, Benjamin</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Feeding and Growth Outcomes in Infants with Type C Esophageal Atresia Who Undergo Early Primary Repair</atitle><jtitle>The Journal of pediatrics</jtitle><addtitle>J Pediatr</addtitle><date>2022-02</date><risdate>2022</risdate><volume>241</volume><spage>77</spage><epage>82.e1</epage><pages>77-82.e1</pages><issn>0022-3476</issn><eissn>1097-6833</eissn><abstract>To describe growth and feeding outcomes in patients with type C esophageal atresia who underwent early primary repair and to identify predictors for poor growth.
This single-center, retrospective, cohort study included all patients with type C esophageal atresia who underwent early primary repair from 2013 to 2019. Weight-for-age z score (WAZ) was calculated at birth, and every 6 months until 3 years postoperatively. Longitudinal median regression was used to evaluate WAZ over time. A multivariable logistic regression model explored predictors of growth outcomes.
Of 46 infants who met the inclusion criteria, 72% were term. The median age at repair was 1.5 days of life (IQR, 1-2 days of life) and the hospital length of stay was 20 days (IQR-14, 30 days). Two patients had esophageal leak (4.3%). The median WAZ at birth was below average (−0.72; IQR, −1.37 to −0.40), but improved to reach average by 3 years (−0.025; IQR, −0.85 to 0.97, P < .001). At discharge, 72% of patients were receiving full oral nutrition, which improved to 95% by 3 years. The only independent predictor of poor growth at 1 year (WAZ < −1 [33%]) was WAZ at discharge (P = .02).
Infants with esophageal atresia who undergo early primary repair are capable of achieving standard growth curves by 3 years of age. However, poor discharge WAZ score was predictive of poor WAZ score at 1 year. Efforts to identify at-risk patients and institute targeted inpatient and outpatient nutrition interventions are needed to improve their growth trajectory.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>34687688</pmid><doi>10.1016/j.jpeds.2021.10.012</doi><orcidid>https://orcid.org/0000-0002-7588-7596</orcidid><orcidid>https://orcid.org/0000-0002-8311-9255</orcidid><orcidid>https://orcid.org/0000-0003-3610-6942</orcidid><orcidid>https://orcid.org/0000-0002-2450-0988</orcidid></addata></record> |
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| subjects | Child Development Child, Preschool Cohort Studies esophageal atresia Esophageal Atresia - surgery Female growth Humans Infant Infant, Newborn Male Nutritional Status Retrospective Studies |
| title | Feeding and Growth Outcomes in Infants with Type C Esophageal Atresia Who Undergo Early Primary Repair |
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