Long-term growth and neurodevelopmental outcomes of a standardized gastroschisis feeding protocol: A retrospective cohort study.

AIM: To evaluate the long-term impact of a standardized feeding protocol on growth and neurodevelopmental outcomes in neonates with simple gastroschisis.

METHODS

A single-center, retrospective cohort study compared pre- and post-feeding protocol outcomes for neonates with simple gastroschisis. Primary outcomes included anthropometric growth z-scores and neurodevelopmental assessment at three and twelve months. Secondary outcomes included neonatal intensive care unit length of stay and total parenteral nutrition duration.

RESULTS

The study included 126 neonates admitted from January 2010 to June 2024, categorized into pre-protocol (n = 55) and post-protocol (n = 71) cohorts. In the multivariate linear regression analysis, the post-protocol group demonstrated significantly higher weight z-scores at 3 months (Beta = 0.64, 95% CI: 0.01 to 1.22; p = 0.029), though this advantage was not sustained at 12 months. Neurodevelopmental assessment revealed no significant differences in cognitive or motor delays at 12 months. A transient reduction in language delay was observed at three months in the post-protocol group (7.1% vs 29.2%, adjusted OR 0.06; p = 0.039), but this did not persist at one year. The protocol was associated with significantly reduced duration of total parenteral nutrition (455.9 h vs 624.5 h; p = 0.009) and shorter length of stay (25.5 days vs 34.5 days; p = 0.004). Attrition analysis showed no significant clinical differences despite higher post-protocol follow-up loss.

CONCLUSION

Standardized feeding protocol significantly improved acute care efficiency by reducing hospital stay and reliance on total parenteral nutrition without compromising long-term growth trajectories or neurodevelopmental outcomes at one year of age. These findings confirm the safety of protocolized feeding for simple gastroschisis.