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. 2025 Apr 10:10.1038/s41372-025-02301-5.
doi: 10.1038/s41372-025-02301-5. Online ahead of print.

Gastroesophageal reflux during postpyloric versus gastric tube feeding in preterm infants with bronchopulmonary dysplasia

Erik A Jensen  1 , Carolyn M Orians  2 , Kathleen Gibbs  2 , Matthew Ryan  3
Affiliations

Gastroesophageal reflux during postpyloric versus gastric tube feeding in preterm infants with bronchopulmonary dysplasia

Erik A Jensen et al. J Perinatol. .

Abstract

Background: Whether postpyloric feeding reduces gastroesophageal reflux (GER) in very preterm infants with bronchopulmonary dysplasia (BPD) is uncertain.

Methods: Prospective observational study comparing GER profiles measured using 24-h esophageal pH-impedance monitoring in infants with BPD receiving clinically prescribed postpyloric (n = 21) or gastric (n = 24) tube feeding.

Results: Participants (median gestational age 25.0 weeks, IQR 24.1-26.9) underwent testing at a median postmenstrual age of 46.6 weeks (IQR 42.7-52.4). The number of GER episodes recorded by impedance varied widely (median 27, range 1-195). Postpyloric versus gastric feeding was associated with fewer GER episodes (median, IQR: 16, 5-41 vs. 40, 19-60; p = 0.07) and less exposure of the proximal esophagus to reflux (median duration, IQR: 0.1 min, 0.005-0.6 vs. 0.77 min, 0.16-1.8; p = 0.045), but a higher proportion of acidic (pH < 4) GER episodes (median, IQR: 91%, 70-100 vs. 31%, 16-54; p < 0.001).

Conclusion: Postpyloric feeding may reduce total GER burden but increase the relative proportion of acidic GER in infants with BPD.

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Conflict of interest statement

Competing interests: The authors declare no competing of interests. Ethics approval and consent to participate: The study protocol, including all described study data collections and diagnostic procedures, were approved by the Institutional Review Board at the Children’s Hospital of Philadelphia (IRB Study Number – 19-016537) and were performed in adherence with all relevant guidelines and regulations. Informed, written parental consent was obtained for each study participant prior to initiating study procedures.

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References

    1. Vakil N, van Zanten SV, Kahrilas P, Dent J, Jones R, Global Consensus Group. The Montreal definition and classification of gastroesophageal reflux disease: a global evidence-based consensus. Am J Gastroenterol 2006, 101(8): 1900–1920. - PubMed
    1. Akinola E, Rosenkrantz TS, Pappagallo M, McKay K, Hussain N. Gastroesophageal reflux in infants < 32 weeks gestational age at birth: lack of relationship to chronic lung disease. Am J Perinatol 2004, 21(2): 57–62. - PubMed
    1. Nobile S, Noviello C, Cobellis G, Carnielli VP. Are infants with bronchopulmonary dysplasia prone to gastroesophageal reflux? A prospective observational study with esophageal pH-impedance monitoring. J Pediatr 2015, 167(2): 279–285.e271. - PubMed
    1. Jadcherla SR, Slaughter JL, Stenger MR, Klebanoff M, Kelleher K, Gardner W. Practice variance, prevalence, and economic burden of premature infants diagnosed with GERD. Hosp Pediatr 2013, 3(4): 335–341. - PMC - PubMed
    1. Wang LJ, Hu Y, Wang W, Zhang CY, Bai YZ, Zhang SC. Gastroesophageal reflux poses a potential risk for late complications of bronchopulmonary dysplasia: a prospective cohort study. Chest 2020, 158(4): 1596–1605. - PubMed

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