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. 2022 Jan;42(1):126-131.
doi: 10.1038/s41372-021-01219-y. Epub 2021 Oct 9.

A predictive model for preterm babies born < 30 weeks gestational age who will not attain full oral feedings

Daniel B Gehle  1 , Alison Chapman  1 , Mathew Gregoski  2 , Meghan Brunswick  3 , Emily Anderson  4 , Viswanathan Ramakrishnan  2 , Lutfiyya N Muhammad  5 , William Head  6 , Aaron P Lesher  7 , Rita M Ryan  1   8
Affiliations

A predictive model for preterm babies born < 30 weeks gestational age who will not attain full oral feedings

Daniel B Gehle et al. J Perinatol. 2022 Jan.

Abstract

Objective: Develop a model to predict gastrostomy tube (GT) for feeding at discharge in infants born < 30 weeks' (w) gestational age (GA).

Study design: A single-center retrospective study at academic NICU. Total of 391 (78 GT, 313 non-GT) infants < 30 w GA admitted in 2015-2018 split into test (15-16) and validation (17-18) cohorts. Classification and regression tree analysis was used to identify predictive factors for GT.

Results: Several factors were associated with GT requirements. Four factors included in the model were postmenstrual age (PMA) at first oral feeding, birth GA, high-frequency ventilation exposure, necrotizing enterocolitis stage II/III. Area under the receiver operator characteristic curve was 0.944 in the test cohort, 0.815 in the validation cohort. Implementation plan based on the model was developed.

Conclusions: We developed a predictive model to risk-stratify infants born < 30 w GA for failing full oral feeding. We hope implementation at 38 w PMA will result in earlier placement of needed GT and discharge.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1. Consort diagram for test cohort, demonstrating exclusion criteria application and remaining cohort.
DOL day of life, PMA post-menstrual age.
Fig. 2
Fig. 2. Feeding data for test cohort by group.
A Quadratic fit for mean mL/kg/day by day of oral feeding attempt, with 95% confidence limits. B Linear fit for mean mL/kg/day by PMA, with 95% confidence limits. Data from infants who never attempted oral feeding were excluded. Data from days after infants were discharged were counted as missing.
See this image and copyright information in PMC

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