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. 2025 May;45(5):616-621.
doi: 10.1038/s41372-025-02238-9. Epub 2025 Feb 22.

Medical treatment of gastroesophageal reflux in the neonatal intensive care unit: current practice

Chelsea Lockyear  1 , Ashley Stark  1 , Henry P Foote  1 , Anthony Agyeman  2 , Manar Bouleqcha  2 , Noam Cohen  2 , Clare Matusevich  2 , Ansley Pantsari  2 , Shuyan Wang  2 , Sharla Rent  1 , William Malcolm  1 , Veeral N Tolia  3 , Rachel G Greenberg  1   2 , Samia Aleem  4
Affiliations

Medical treatment of gastroesophageal reflux in the neonatal intensive care unit: current practice

Chelsea Lockyear et al. J Perinatol. 2025 May.

Abstract

Objective: To determine current prescribing practice of acid-suppressive therapy in preterm infants admitted to the neonatal intensive care unit (NICU).

Study design: Cohort study of infants 22 to 27 weeks gestation discharged from Pediatrix Medical Group NICUs between 2015 and 2020.

Results: Of 13,735 infants meeting inclusion criteria, 11% were exposed to acid-suppressive therapy during hospitalization, with 3% of those treated on the day of discharge. Exposed infants had lower birthweights (BW) (p < 0.001). 42% of infants exposed to acid-suppressive therapy received a gastroesophageal reflux disease (GERD) diagnosis (p < 0.001). Median (25th-75th percentile) duration of use was 7 (4-14) days. Use decreased overall during the 5-year period (p < 0.001).

Conclusion: Acid-suppressive therapies are used commonly in preterm infants and receipt is higher in infants with lower BWs. Use has significantly decreased over time and appears to be targeted, with many infants treated for one-week courses and without a diagnosis of GERD.

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Conflict of interest statement

Competing interests: The authors declare no competing interests. Ethics approval: This study was approved as exempt research by the Duke University Institutional Review Board under a waiver of consent. This study was performed in accordance with the Declaration of Helsinki.

Figures

Figure 1:
Figure 1:
Proton pump inhibitor use and H2 receptor antagonist use by year
Figure 2:
Figure 2:
Acid-suppressive therapy percent use in 22–27 week infants by center
See this image and copyright information in PMC

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