Longitudinal evaluation of growth in oesophageal atresia patients up to 12 years

Abstract

Objective: Previous studies reported diminished growth after oesophageal atresia (OA) repair. We evaluated long-term follow-up data on growth.

Methods: Longitudinal cohort study up to 12 years. Patients with OA, born 1999-2013, who participated in a longitudinal follow-up programme were included. Children with genetic syndromes associated with growth disorders were excluded. SD scores (SDS) for height-for-age (HFA), weight-for-height (WFH) and distance-to-target-height were calculated for routine visits (0.5/1/2/5/8/12 years). Linear mixed models were used to estimate SDS until 12 years of age and to evaluate explanatory factors for growth.

Results: We included 126/155 children (32% prematurely born, 20% small for gestational age), 32 reached the age of 12 years. Fundoplication surgery was performed in 24%. SDS-HFA was below normal up to 8 years but improved over these years (mean (SE) -0.48 (0.09), -0.31 (0.09) and -0.20 (0.13) at 0.5, 8 and 12 years). Scores improved after correction for target height (mean (SE) -0.29 (0.10), -0.17 (0.09) and -0.10 (0.14) at 0.5, 8 and 12 years). SDS-WFH was below normal from age 1-5 years (mean (SE) -0.53 (0.09), -0.24 (0.09) and 0.03 (0.14) at 1, 5 and 12 years). Low birth weight and fundoplication surgery were negatively associated with growth.

Conclusions: The growth of patients with OA was below the reference norm during the first years of life, but normalised at 12 years. Large longitudinal cohort studies should evaluate if normal growth persists into adolescence. Early nutritional assessment with timely dietary intervention should be considered especially in those with low birth weight or following fundoplication surgery.

Keywords: Growth; Malnutrition; Oesophageal atresia; Outcome; Risk factors.