Growth pattern of infants with gastroschisis in the neonatal period

• Published in: Clinical nutrition ESPEN Vol. 32; pp. 82 - 87
• Main Authors: Hall, Nigel J, Drewett, Melanie, Burge, David M, Eaton, Simon
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01-08-2019
• Subjects: Gastroenterology and Hepatology
• ISSN: 2405-4577; 2405-4577
• DOI: 10.1016/j.clnesp.2019.04.008

SummaryBackground/AimEarly postnatal growth patterns may have significant long term health effects. Although preterm infants on parenteral nutrition (PN) exhibit poor growth, growth pattern of term or near-term infants requiring PN is not well reported. We aimed to investigate this in infants born with gastroschisis.MethodsRetrospective review of all infants with gastroschisis requiring PN treated at a single centre over a 4 year period. Growth and clinical data were retrieved, and weight SDS scores for corrected gestational age calculated. Weight SDS (mean ± SD) were compared at clinically relevant timepoints and multi-level regression used to model growth trends over time.Main resultsDuring the study period 61 infants with gastroschisis were treated; all were included. Infants were small for gestational age at birth for weight (SDS score −0.87 ± 0.85). Weight SDS decreased significantly during the first 10 days of age (mean decrease 0.81 ± 0.56; p < 0.0001) and between birth and discharge (mean decrease 0.81 ± 0.56; p < 0.0001). Despite tolerating full enteral feeds, weight SDS velocity was negative around the time of transition from parenteral to enteral feed. There was evidence of ‘catch up’ growth between 3 and 6 months of age.ConclusionDespite nutritional support with PN, infants with gastroschisis demonstrate significant growth failure during the newborn period. Further efforts are required to understand the underlying mechanisms, improve nutritional support and to evaluate the long term consequences of postnatal growth failure in this population.