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
Main Authors: Puia‐Dumitrescu, Mihai, Benjamin, Daniel K., Smith, P. Brian, Greenberg, Rachel G., Abuzaid, Nada, Andrews, Winsome, Chellani, Kris, Gupta, Anjali, Price, Douglas, Williams, Ciara, Malcolm, William F., Clark, Reese H., Zimmerman, Kanecia O.
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Language:English
Published: United States 01-02-2020
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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.
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
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– name: 5 Pediatrix-Obstetrix Center for Research and Education, Sunrise, FL, USA
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crossref_primary_10_1542_hpeds_2021_006102
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Keywords premature infants
gastrostomy tube
weight gain
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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.
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Snippet 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...
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...
SourceID pubmedcentral
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SourceType Open Access Repository
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StartPage 355
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
URI https://onlinelibrary.wiley.com/doi/abs/10.1002%2Fjpen.1539
https://www.ncbi.nlm.nih.gov/pubmed/30908714
https://www.proquest.com/docview/2197888225
https://pubmed.ncbi.nlm.nih.gov/PMC7295029
Volume 44
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