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Multicenter Study
. 2021 Jun:233:112-118.e3.
doi: 10.1016/j.jpeds.2021.02.013. Epub 2021 Feb 26.

Growth Failure Prevalence in Neonates with Gastroschisis : A Statewide Cohort Study

Katie M Strobel  1 , Tahmineh Romero  2 , Katelin Kramer  3 , Erika Fernandez  4 , Catherine Rottkamp  5 , Cherry Uy  6 , Roberta Keller  3 , Laurel Moyer  7 , Francis Poulain  5 , Jae H Kim  4 , Daniel A DeUgarte  8 , Kara L Calkins  9 ; University of California Fetal Consortium
Collaborators, Affiliations
Multicenter Study

Growth Failure Prevalence in Neonates with Gastroschisis : A Statewide Cohort Study

Katie M Strobel et al. J Pediatr. 2021 Jun.

Abstract

Objectives: To perform a multicenter study to assess growth failure in hospitalized infants with gastroschisis.

Study design: This study included neonates with gastroschisis within sites in the University of California Fetal Consortium. The study's primary outcome was growth failure at hospital discharge, defined as a weight or length z score decrease >0.8 from birth. Regression analysis was performed to assess changes in z scores over time.

Results: Among 125 infants with gastroschisis, the median gestational age was 37 weeks (IQR 35-37). Length of stay was 32 days (23-60); 55% developed weight or length growth failure at discharge (28% had weight growth failure, 42% had length growth failure, and 15% had both weight and length growth failure). Weight and length z scores at 14 days, 30 days, and discharge were less than birth (P < .01 for all). Weight and length z scores declined from birth to 30 days (-0.10 and -0.11 z score units/week, respectively, P < .001). Length growth failure at discharge was associated with weight and length z score changes over time (P < .05 for both). Lower gestational age was associated with weight growth failure (OR 0.70 for each gestational age week, 95% CI 0.55-0.89, P = .004).

Conclusions: Growth failure, in particular linear growth failure, is common in infants with gastroschisis. These data suggest the need to improve nutritional management in these infants.

Keywords: gastrointestinal anomaly; growth velocity; infants; prematurity; z score.

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Figures

Figure 1.
Figure 1.
Mean weight (A), length (B), and head circumference (HC) (C) z-scores from birth to 30 days. Circles represent those who had no growth failure (weight or length) at discharge. Squares represent those who had growth failure (weight or length) at discharge. Error bars represent standard deviation. The change in weight z-score from birth to 30 days was significantly different between those who developed growth failure at discharge compared those who did not (−0.13 versus −0.07 z-score units/week, p=0.004). The change in length z-score from birth to 30 days was significantly different between these two groups (−0.54 versus 0.16 z-score units/week, p=0.023). There was no significant difference in head circumference z-score changes from birth to 30 days between groups (−0.0050 versus 0.0067 z-score units/week, p=0.086).
Figure 2.
Figure 2.
Mean weight z-score from birth to 30 days in infants who are small for gestational age versus infants who are appropriate for gestational age.
See this image and copyright information in PMC

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