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Gastrostomy tube placement common among ELBW babies

31 Oct 2019
Premature babies are prone to birth-related complications, with effects running well into their lives if they do not first succumb to death.

Infants born extremely low birth weight (ELBW) are likely to require gastrostomy tube (GT) placement, especially those with severe neonatal morbidities, a recent study has found.

A total of 4,549 ELBW infants (mean gestational age, 25.73±1.30 weeks; 49 percent male) were included in the present analysis. Accessing the databases and follow-up registries of 25 medical participating centres, researchers obtained the information about long-term outcomes and GT placement before 18–22 months of age.

Majority of the participants did not have GTs (n=4,216); only 333 infants required placement. The resulting prevalence rate was 7.3 percent. The latter group was significantly more likely to develop adverse long-term outcomes, such as breathing and feeding problems, moderate or severe cerebral palsy, and neurodevelopmental impairments (p-all<0.01).

Logistic regression analysis was then performed to identify characteristic variables associated with an increased likelihood of GT placement. Small for gestational age (odds ratio [OR], 1.92, 95 percent CI, 1.31–2.84; p<0.01) and length of hospital stay (OR, 1.02, 1.02–1.02; p<0.01) emerged as significant risk factors.

The same was true for having chronic breathing (OR, 2.42, 1.89–3.10; p<0.01) and feeding (OR, 4.06, 3.12–5.28; p<0.01), as well as moderate or severe cerebral palsy (OR, 4.60, 3.25–6.50; p<0.01). Necrotizing enterocolitis, on the other hand, did not emerge as a significant risk factor (OR, 1.13, 0.70–1.81; p=0.61).

The present findings highlight the need for stricter nutritional follow-up of ELBW infants, said researchers. Future studies are needed to better understand the optimal timing of GT placement and for the standardization of oral infant feeding guidelines.

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