Impact of Gastrostomy Tube Placement on Short‐Term Weight Gain in Hospitalized Premature Infants
Background Gastrostomy tube (G‐tube) placement is a long‐term alternative to oral or nasogastric feeding for premature infants who cannot safely feed orally or need supplemental nutrition for adequate growth. Methods We compared daily weight changes for G‐tube infants 14 and 30 days preplacement and...
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Published in: | JPEN. Journal of parenteral and enteral nutrition Vol. 44; no. 2; pp. 355 - 360 |
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Abstract | Background
Gastrostomy tube (G‐tube) placement is a long‐term alternative to oral or nasogastric feeding for premature infants who cannot safely feed orally or need supplemental nutrition for adequate growth.
Methods
We compared daily weight changes for G‐tube infants 14 and 30 days preplacement and postplacement, excluding the first 7 days post–G‐tube insertion. Infants <37 weeks of gestation without major congenital anomalies and discharged from 327 United States neonatal intensive care units (2004–2013) were included. Incidence of in‐hospital outcomes including hypoxic ischemic encephalopathy, intraventricular hemorrhage grade 3 or 4, necrotizing enterocolitis, and patent ductus arteriosus ligation was examined. Additionally, we estimated a treatment effect model in which infants with a G‐tube were matched 1:1 to untreated controls based on propensity scores; main outcome was the average treatment effect (weight gain) for treated infants during the 7, 14, or 30 days immediately prior to discharge.
Results
Of 329,254 infants, 1393 (0.4%) received a G‐tube, increasing from 0.2% in 2004 to 0.6% in 2013. Daily weight gain was significantly less during days 8–14 postplacement compared with 14 days preplacement but was similar between 30 days preplacement and 8–30 days postplacement. After matching, G‐tube infant weight gain during the 7 days predischarge was less than among controls, but there was no difference in weight gain between treated and control patients for 14 days and 30 days predischarge.
Conclusions
The prevalence of G‐tube placement has increased. G‐tube use in infants was not associated with improved short‐term daily weight gain. |
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AbstractList | Gastrostomy tube (G-tube) placement is a long-term alternative to oral or nasogastric feeding for premature infants who cannot safely feed orally or need supplemental nutrition for adequate growth.BACKGROUNDGastrostomy tube (G-tube) placement is a long-term alternative to oral or nasogastric feeding for premature infants who cannot safely feed orally or need supplemental nutrition for adequate growth.We compared daily weight changes for G-tube infants 14 and 30 days preplacement and postplacement, excluding the first 7 days post-G-tube insertion. Infants <37 weeks of gestation without major congenital anomalies and discharged from 327 United States neonatal intensive care units (2004-2013) were included. Incidence of in-hospital outcomes including hypoxic ischemic encephalopathy, intraventricular hemorrhage grade 3 or 4, necrotizing enterocolitis, and patent ductus arteriosus ligation was examined. Additionally, we estimated a treatment effect model in which infants with a G-tube were matched 1:1 to untreated controls based on propensity scores; main outcome was the average treatment effect (weight gain) for treated infants during the 7, 14, or 30 days immediately prior to discharge.METHODSWe compared daily weight changes for G-tube infants 14 and 30 days preplacement and postplacement, excluding the first 7 days post-G-tube insertion. Infants <37 weeks of gestation without major congenital anomalies and discharged from 327 United States neonatal intensive care units (2004-2013) were included. Incidence of in-hospital outcomes including hypoxic ischemic encephalopathy, intraventricular hemorrhage grade 3 or 4, necrotizing enterocolitis, and patent ductus arteriosus ligation was examined. Additionally, we estimated a treatment effect model in which infants with a G-tube were matched 1:1 to untreated controls based on propensity scores; main outcome was the average treatment effect (weight gain) for treated infants during the 7, 14, or 30 days immediately prior to discharge.Of 329,254 infants, 1393 (0.4%) received a G-tube, increasing from 0.2% in 2004 to 0.6% in 2013. Daily weight gain was significantly less during days 8-14 postplacement compared with 14 days preplacement but was similar between 30 days preplacement and 8-30 days postplacement. After matching, G-tube infant weight gain during the 7 days predischarge was less than among controls, but there was no difference in weight gain between treated and control patients for 14 days and 30 days predischarge.RESULTSOf 329,254 infants, 1393 (0.4%) received a G-tube, increasing from 0.2% in 2004 to 0.6% in 2013. Daily weight gain was significantly less during days 8-14 postplacement compared with 14 days preplacement but was similar between 30 days preplacement and 8-30 days postplacement. After matching, G-tube infant weight gain during the 7 days predischarge was less than among controls, but there was no difference in weight gain between treated and control patients for 14 days and 30 days predischarge.The prevalence of G-tube placement has increased. G-tube use in infants was not associated with improved short-term daily weight gain.CONCLUSIONSThe prevalence of G-tube placement has increased. G-tube use in infants was not associated with improved short-term daily weight gain. Gastrostomy tube (G-tube) placement is a long-term alternative to oral or nasogastric feeding for premature infants who cannot safely feed orally or need supplemental nutrition for adequate growth. We compared daily weight changes for G-tube infants 14 and 30 days preplacement and postplacement, excluding the first 7 days post-G-tube insertion. Infants <37 weeks of gestation without major congenital anomalies and discharged from 327 United States neonatal intensive care units (2004-2013) were included. Incidence of in-hospital outcomes including hypoxic ischemic encephalopathy, intraventricular hemorrhage grade 3 or 4, necrotizing enterocolitis, and patent ductus arteriosus ligation was examined. Additionally, we estimated a treatment effect model in which infants with a G-tube were matched 1:1 to untreated controls based on propensity scores; main outcome was the average treatment effect (weight gain) for treated infants during the 7, 14, or 30 days immediately prior to discharge. Of 329,254 infants, 1393 (0.4%) received a G-tube, increasing from 0.2% in 2004 to 0.6% in 2013. Daily weight gain was significantly less during days 8-14 postplacement compared with 14 days preplacement but was similar between 30 days preplacement and 8-30 days postplacement. After matching, G-tube infant weight gain during the 7 days predischarge was less than among controls, but there was no difference in weight gain between treated and control patients for 14 days and 30 days predischarge. The prevalence of G-tube placement has increased. G-tube use in infants was not associated with improved short-term daily weight gain. Background Gastrostomy tube (G‐tube) placement is a long‐term alternative to oral or nasogastric feeding for premature infants who cannot safely feed orally or need supplemental nutrition for adequate growth. Methods We compared daily weight changes for G‐tube infants 14 and 30 days preplacement and postplacement, excluding the first 7 days post–G‐tube insertion. Infants <37 weeks of gestation without major congenital anomalies and discharged from 327 United States neonatal intensive care units (2004–2013) were included. Incidence of in‐hospital outcomes including hypoxic ischemic encephalopathy, intraventricular hemorrhage grade 3 or 4, necrotizing enterocolitis, and patent ductus arteriosus ligation was examined. Additionally, we estimated a treatment effect model in which infants with a G‐tube were matched 1:1 to untreated controls based on propensity scores; main outcome was the average treatment effect (weight gain) for treated infants during the 7, 14, or 30 days immediately prior to discharge. Results Of 329,254 infants, 1393 (0.4%) received a G‐tube, increasing from 0.2% in 2004 to 0.6% in 2013. Daily weight gain was significantly less during days 8–14 postplacement compared with 14 days preplacement but was similar between 30 days preplacement and 8–30 days postplacement. After matching, G‐tube infant weight gain during the 7 days predischarge was less than among controls, but there was no difference in weight gain between treated and control patients for 14 days and 30 days predischarge. Conclusions The prevalence of G‐tube placement has increased. G‐tube use in infants was not associated with improved short‐term daily weight gain. |
Author | Puia‐Dumitrescu, Mihai Chellani, Kris Smith, P. Brian Price, Douglas Malcolm, William F. Andrews, Winsome Greenberg, Rachel G. Clark, Reese H. Gupta, Anjali Zimmerman, Kanecia O. Benjamin, Daniel K. Abuzaid, Nada Williams, Ciara |
AuthorAffiliation | 3 Clemson University, Department of Economics, Clemson, SC, USA 5 Pediatrix-Obstetrix Center for Research and Education, Sunrise, FL, USA 2 Department of Pediatrics, Duke University Medical Center, Durham, NC, USA 4 Duke Clinical Research Institute, Durham, NC, USA 1 Department of Pediatrics, University of Washington, Seattle, WA, USA |
AuthorAffiliation_xml | – name: 4 Duke Clinical Research Institute, Durham, NC, USA – name: 1 Department of Pediatrics, University of Washington, Seattle, WA, USA – name: 3 Clemson University, Department of Economics, Clemson, SC, USA – name: 2 Department of Pediatrics, Duke University Medical Center, Durham, NC, USA – name: 5 Pediatrix-Obstetrix Center for Research and Education, Sunrise, FL, USA |
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BackLink | https://www.ncbi.nlm.nih.gov/pubmed/30908714$$D View this record in MEDLINE/PubMed |
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Notes | High school student affiliated with the Duke Clinical Research Institute R25 Summer Program. Financial disclosure: Dr. Puia‐Dumitrescu received salary support from the National Institutes of Health (T32 HD 43029‐13 and T32 HD 43029‐14, PI: Benjamin). This work was funded under National Institute of Child Health and Human Development contract HHSN275201000003I for the Pediatric Trials Network (PI: Benjamin). The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH. Conflicts of interest: None declared. ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 High school student affiliated with the Duke Clinical Research Institute R25 Summer Program |
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References | 2006; 91 2013; 48 2012; 2 2010; 37 2013; 28 1990; 14 2006; 48 2011; 53 2014; 59 2013; 163 2016; 103 2011; 6 1988; 82 2012; 32 2005; 66 2010; 50 2003; 45 2005; 47 e_1_2_8_17_1 e_1_2_8_19_1 e_1_2_8_13_1 e_1_2_8_14_1 e_1_2_8_15_1 e_1_2_8_16_1 Rempel GR (e_1_2_8_18_1) 1988; 82 e_1_2_8_3_1 e_1_2_8_2_1 e_1_2_8_5_1 e_1_2_8_4_1 e_1_2_8_7_1 e_1_2_8_6_1 e_1_2_8_9_1 e_1_2_8_8_1 e_1_2_8_20_1 e_1_2_8_10_1 e_1_2_8_21_1 e_1_2_8_11_1 e_1_2_8_22_1 e_1_2_8_12_1 |
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Gastrostomy tube (G‐tube) placement is a long‐term alternative to oral or nasogastric feeding for premature infants who cannot safely feed orally or... Gastrostomy tube (G-tube) placement is a long-term alternative to oral or nasogastric feeding for premature infants who cannot safely feed orally or need... |
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SubjectTerms | Cesarean Section Enteral Nutrition Female Gastrostomy gastrostomy tube Humans Infant Infant, Newborn Infant, Premature Male Pregnancy premature infants Weight Gain |
Title | Impact of Gastrostomy Tube Placement on Short‐Term Weight Gain in Hospitalized Premature Infants |
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