Nutrition Delivery and Growth Outcomes in Infants With Gastroschisis

Hong, Charles R.; Zurakowski, David; Fullerton, Brenna S.; Ariagno, Katelyn; Jaksic, Tom; Mehta, Nilesh M.

doi:10.1002/jpen.1022

Cited by 17 publications

(14 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…While some studies have appreciated this U-shaped growth trajectory, others have not. 4,5,9,11,27 Catch-up growth in infants with congenital GI anomalies may lead to increased lean body mass and improved neurodevelopment. 16,28 In a study by Plummer et al, in preschool age children with congenital GI anomalies, a greater amount of fat-free mass was associated with higher test scores.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Growth from Birth to 30 months for Infants Born with Congenital Gastrointestinal Anomalies and Disorders

et al. 2020

View full text Add to dashboard Cite

Objective This study aimed to investigate growth among neonates with gastrointestinal disorders. Study Design Inclusion criteria included neonates with gastroschisis, omphalocele, intestinal atresia, tracheoesophageal fistula, Hirschsprung's disease, malabsorption disorders, congenital diaphragmatic hernia, and imperforate anus born between 2010 and 2018. Anthropometrics were collected for the first 30 months, and a subgroup analysis was performed for gastroschisis infants. Results In 61 subjects, 13% developed severe growth failure within the first month. One-, four-, and nine-month weight and length z-scores were less than birth weight in all infants (p < 0.05). In infants with gastroschisis, a similar pattern was observed for weight z-scores only (p < 0.05). From birth to 15 months, head circumference z-score increased over time in all infants (p = 0.001), while in gastroschisis infants, weight, length, and head circumference z-scores increased over time (p < 0.05). Conclusion In a cohort of infants with gastrointestinal disorders, growth failure was followed by catch-up growth.

show abstract

Section: Discussionmentioning

confidence: 99%

“…However, these infants are at high risk for growth failure. [1][2][3][4][5][6][7][8][9][10] These infants have prolonged stays in the neonatal intensive care unit due to feeding intolerance, intestinal surgeries, necrotizing enterocolitis, and sepsis. Moreover, these infants are often born prematurely and at risk for intestinal failure.…”

mentioning

confidence: 99%

Growth from Birth to 30 months for Infants Born with Congenital Gastrointestinal Anomalies and Disorders

et al. 2020

View full text Add to dashboard Cite

show abstract

“…Numerous studies have questioned the best feeding practices for infants with gastroschisis. 26,35 Therefore, we evaluated the change in weight z-score versus the day of life on which enteral feeds were initiated (►Fig. 4A) or the day of life the full enteral feeds were achieved (►Fig.…”

Section: Discussionmentioning

confidence: 99%

“…Several studies have proposed that infants with gastroschisis are growth restricted at birth, continue to be at risk for long-term growth delay, especially if they are born SGA, and that their decline in growth over time can be predicted by factors such as prematurity and central line-associated bloodstream infections. 1,[25][26][27][28][29][30][31] However, the exact associations among these factors remain largely unknown as a result of study limitations such as small cohort sizes, unsuitable inclusion criteria, and insufficient data points over time. This study aims to further investigate the potential factors that influence postnatal growth outcomes in infants with gastroschisis from birth to 18 months of age.…”

mentioning

confidence: 99%

Factors that Influence Longitudinal Growth from Birth to 18 Months of Age in Infants with Gastroschisis

et al. 2019

View full text Add to dashboard Cite

Objective To investigate factors that influence growth in infants with gastroschisis. Study Design Growth parameters at birth, discharge, 6, 12, and 18 months of age were collected from 42 infants with gastroschisis. Results The mean z-scores for weight, length, and head circumference were below normal at birth and decreased between birth and discharge. Lower gestational age correlated with a worsening change in weight z-score from birth to discharge (rho 0.38, p = 0.01), but not with the change in weight z-score from discharge to 18 months (rho 0.04, p = 0.81). There was no correlation between the day of life when the enteral feeds were started and the change in weight z-score from birth to discharge (rho 0.12, p = 0.44) or discharge to 18 months (rho −0.15, p = 0.41). Conclusion Our study demonstrates that infants with gastroschisis experience a significant decline in weight z-score between birth and discharge, and start to catch up on all growth parameters after discharge. Prematurity in gastroschisis infants is associated with a greater risk for weight loss during this time. This information emphasizes the importance of minimizing weight loss prior to discharge in premature infants with gastroschisis and highlights the need for optimal management strategies for these infants.

show abstract

“…In addition to surgical repair, strategies for managing such conditions include early commencement of enteral feeds, standardization of feeding advancement, strict hand hygiene and aseptic precautions for indwelling catheters (Graham, ; Lauriti et al ., ; Savoie et al ., ; Dama et al ., ). Despite such best practices and advances in surgical techniques, morbidities including feed intolerance, healthcare‐associated infections, cholestatic jaundice, growth failure and neurodevelopmental disabilities continue to impose significant health burden on this cohort (Willis et al ., ; Bishay et al ., ; Wang et al ., ; Dwyer et al ., ; Hong et al ., ). Additional strategies are hence required to improve their outcomes.…”

mentioning

confidence: 97%

Probiotic research in neonates with congenital gastrointestinal surgical conditions – Now is the time

Rao

Patole

2018

Microbial Biotechnology

View full text Add to dashboard Cite

Summary Neonates with congenital gastrointestinal surgical conditions ( CGISC ) receive parenteral nutrition, get exposed to multiple courses of antibiotics, undergo invasive procedures, and are nursed in intensive care units. They do not receive early enteral feeding and have limited opportunities for skin to skin contact with their mothers. Many of these infants receive gastric acid suppression therapies. All these factors increase the risk of gut dysbiosis in these infants. Gut dysbiosis is known to be associated with increased risk of infections and other morbidities in ICU patients. Experimental studies have shown that probiotics inhibit gut colonization with pathogenic bacteria, enhance gut barrier function, facilitate colonization with healthy commensals, protect from enteropathogenic infection through production of acetate, reduce antimicrobial resistance, enhance innate immunity, and increase the maturation of the enteric nervous system and promote gut peristalsis. Through these mechanisms, probiotics have the potential to decrease the risk of sepsis and inflammation, improve feed tolerance and minimise cholestasis in neonates with CGISC . Among preterm non‐surgical infants, evidence from more than 35 RCT s and multiple observational studies have shown probiotics to be safe and beneficial. A RCT in neonates (N=24) with gastroschisis found that probiotic supplementation partially attenuated gut dysbiosis. Two ongoing RCT s (total N=168) in neonates with gastrointestinal surgical conditions are expected to provide feasibility data to enable the conduct of large RCT s. Rigorous quality assurance of the probiotic product, ongoing microbial surveillance and clinical vigilance are warranted while conducting such RCT s.

show abstract

Nutrition Delivery and Growth Outcomes in Infants With Gastroschisis

Abstract: Infants with gastroschisis are dependent on PN and have a significant decline in WAZ during their hospital stay, predicted by prematurity and CLABSI. Efforts to prevent CLABSI and optimize enteral autonomy must be prioritized in this cohort.

Cited by 17 publications

References 34 publications

Growth from Birth to 30 months for Infants Born with Congenital Gastrointestinal Anomalies and Disorders

Growth from Birth to 30 months for Infants Born with Congenital Gastrointestinal Anomalies and Disorders

Factors that Influence Longitudinal Growth from Birth to 18 Months of Age in Infants with Gastroschisis

Probiotic research in neonates with congenital gastrointestinal surgical conditions – Now is the time

Contact Info

Product

Resources

About