Feeding Methods at Discharge Predict Long-term Feeding and Neurodevelopmental Outcomes in Preterm Infants Referred for Gastrostomy Evaluation
Autor: | Ish K. Gulati, Tanvi Khot, Rebecca K. Moore, Jonathan L. Slaughter, Sudarshan R. Jadcherla, Manish B. Malkar |
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Jazyk: | angličtina |
Rok vydání: | 2016 |
Předmět: |
Feeding Methods
Male Pediatrics medicine.medical_specialty Neonatal intensive care unit medicine.medical_treatment Developmental Disabilities Gestational Age Article Statistics Nonparametric Cohort Studies 03 medical and health sciences Eating 0302 clinical medicine Enteral Nutrition 030225 pediatrics Intensive Care Units Neonatal medicine Humans 030212 general & internal medicine Retrospective Studies Gastrostomy business.industry Infant Newborn Retrospective cohort study medicine.disease Prognosis Long-Term Care Patient Discharge Intraventricular hemorrhage Logistic Models Treatment Outcome Bronchopulmonary dysplasia Pediatrics Perinatology and Child Health Multivariate Analysis GERD Gestation Female business Infant Premature |
Popis: | To test the hypothesis that oral feeding at first neonatal intensive care unit discharge is associated with less neurodevelopmental impairment and better feeding milestones compared with discharge with a gastrostomy tube (G-tube).We studied outcomes for a retrospective cohort of 194 neonates 37 weeks' gestation referred for evaluation and management of feeding difficulties between July 2006 and July 2012. Discharge milestones, length of hospitalization, and Bayley Scales of Infant Development-Third Edition scores at 18-24 months were examined. χA total of 60% (n = 117) of infants were discharged on oral feedings; of these, 96% remained oral-fed at 1 year. The remaining 40% (n = 77) were discharged on G-tube feedings; of these, 31 (40%) remained G-tube dependent, 17 (22%) became oral-fed, and 29 (38%) were on oral and G-tube feedings at 1 year. Infants discharged on a G-tube had lower cognitive (P .01), communication (P = .03), and motor (P .01) composite scores. The presence of a G-tube, younger gestation, bronchopulmonary dysplasia, or intraventricular hemorrhage was associated significantly with neurodevelopmental delay.For infants referred for feeding concerns, G-tube evaluations, and feeding management, the majority did not require a G-tube. Full oral feeding at first neonatal intensive care unit discharge was associated with superior feeding milestones and less long-term neurodevelopmental impairment, relative to full or partial G-tube feeding. Evaluation and feeding management before and after G-tube placement may improve long-term feeding and neurodevelopmental outcomes. |
Databáze: | OpenAIRE |
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