Need for Gastrostomy Tube in Periviable Infants.

IF 1.5 4区医学 Q3 OBSTETRICS & GYNECOLOGY

American journal of perinatology Pub Date : 2024-10-01 Epub Date: 2024-03-21 DOI:10.1055/s-0044-1781461

Erica E ElSeed Peterson, Jared T Roeckner, Taylor W Deall, Michele Karn, Jose R Duncan, Jaime Flores-Torres, Ambuj Kumar, Tara M Randis

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引用次数: 0

Abstract

Objective: We sought to identify clinical and demographic factors associated with gastrostomy tube (g-tube) placement in periviable infants.

Study design: We conducted a single-center retrospective cohort study of live-born infants between 22 and 25 weeks' gestation. Infants not actively resuscitated and those with congenital anomalies were excluded from analysis.

Results: Of the 243 infants included, 158 survived until discharge. Of those that survived to discharge, 35 required g-tube prior to discharge. Maternal race/ethnicity (p = 0.006), intraventricular hemorrhage (p = 0.013), periventricular leukomalacia (p = 0.003), bronchopulmonary dysplasia (BPD; p ≤ 0.001), and singleton gestation (p = 0.009) were associated with need for gastrostomy. In a multivariable logistic regression, maternal Black race (Odds Ratio [OR] = 2.88; 95% confidence interval [CI]: 1.11-7.47; p = 0.029), singleton gestation (OR = 3.99; 95% CI: 1.28-12.4; p = 0.017) and BPD (zero g-tube placement in the no BPD arm; p ≤ 0.001) were associated with need for g-tube.

Conclusion: A high percentage of periviable infants surviving until discharge require g-tube at our institution. In this single-center retrospective study, we noted that maternal Black race, singleton gestation, and BPD were associated with increased risk for g-tube placement in infants born between 22 and 25 weeks' gestation. The finding of increased risk with maternal Black race is consistent with previous reports of racial/ethnic disparities in preterm morbidities. Additional studies examining factors associated with successful achievement of oral feedings in preterm infants are necessary and will inform future efforts to advance equity in newborn health.

Key points: · BPD, singleton birth, and Black race are associated with need for g-tube in periviable infants.. · Severe intraventricular hemorrhage is associated with increased mortality or g-tube placement in periviable infants.. · Further investigation into the relationship between maternal race and g-tube placement is warranted..

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围产期婴儿是否需要胃造瘘管？

研究目的研究设计：我们对妊娠 22-25 周的活产婴儿进行了单中心回顾性队列研究。分析中排除了未积极抢救的婴儿和先天性异常的婴儿：结果：在纳入的 243 名婴儿中，有 158 名存活到出院。在存活到出院的婴儿中，有 35 名婴儿在出院前需要插胃管。母亲种族/民族（p = 0.006）、脑室内出血（p = 0.013）、脑室周围白质异常（p = 0.003）、支气管肺发育不良（BPD；p ≤ 0.001）和单胎妊娠（p = 0.009）与胃造瘘术的需求有关。在多变量逻辑回归中，母亲的黑人种族（Odds Ratio [OR] 2.88；95% 置信区间 [CI] 1.11-7.47；p = 0.029）、单胎妊娠（OR 3.99；95% CI 1.28-12.4；p = 0.017）和 BPD（无 BPD 组的胃管置入率为零；p ≤ 0.001）与胃管需求相关：结论：在我院，存活至出院的围活期婴儿中需要插管的比例很高。在这项单中心回顾性研究中，我们注意到母亲为黑人、单胎妊娠和 BPD 与妊娠 22-25 周之间出生的婴儿插管风险增加有关。产妇为黑人的风险增加这一发现与之前关于早产儿发病率的种族/民族差异的报道一致。有必要对早产儿成功实现口腔喂养的相关因素进行更多研究，这将为今后促进新生儿健康公平提供信息：- 要点：BPD、单胎分娩和黑人种族与围产期婴儿需要插管有关。- 严重脑室内出血与围活期婴儿死亡率增加或插胃管有关。- 有必要进一步调查产妇种族与插胃管之间的关系。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

American journal of perinatology 医学-妇产科学

CiteScore

5.90

自引率

0.00%

发文量

302

审稿时长

4-8 weeks

期刊介绍： The American Journal of Perinatology is an international, peer-reviewed, and indexed journal publishing 14 issues a year dealing with original research and topical reviews. It is the definitive forum for specialists in obstetrics, neonatology, perinatology, and maternal/fetal medicine, with emphasis on bridging the different fields. The focus is primarily on clinical and translational research, clinical and technical advances in diagnosis, monitoring, and treatment as well as evidence-based reviews. Topics of interest include epidemiology, diagnosis, prevention, and management of maternal, fetal, and neonatal diseases. Manuscripts on new technology, NICU set-ups, and nursing topics are published to provide a broad survey of important issues in this field. All articles undergo rigorous peer review, with web-based submission, expedited turn-around, and availability of electronic publication. The American Journal of Perinatology is accompanied by AJP Reports - an Open Access journal for case reports in neonatology and maternal/fetal medicine.