Pediatrics · 2025
Long-Term Nutritional Status in Children Born With Esophageal Atresia.
СтатьяНазвание и аннотация: Перевод в очереди
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Aumar Madeleine, Depoortere Suzanne, Antoine Matthieu, Tran Lea, Coopman Stephanie, Guimber Dominique, Sfeir Rony, Ley Delphine, Leroy Maxime, Leroy Melanie, Gottrand Frederic
Аннотация
BACKGROUND AND OBJECTIVES: Previous studies have reported early undernutrition and growth delay in children born with esophageal atresia (EA). Our goal was to assess their long-term nutritional status.
METHODS: We longitudinally studied 204 children born with EA (91% with tracheoesophageal fistula) from birth to 16 years. Undernutrition (Z-score for body mass index [BMI] < -2 SD), and stunting (Z-score for height for age [HFA] < -2 SD) were evaluated. Risk factors were analyzed using regression models for interval-censored data.
RESULTS: The mean Z-BMI and Z-HFA were lower in children with EA than the normal population from birth to age 16 years. At 12 years, the Z-BMI had increased closer to the normal range, but the Z-HFA still differed from the normal range. The cumulative incidence of wasting was 7% (95% CI, 5-12) among 1-year-olds with EA and 25% (95% CI, 19-31) of this population were undernourished at least once between ages 1 and 16 years. Undernutrition was significantly associated with congenital heart malformation (hazard ratio [HR] 2.7 [1.5-5.1]), prenatal EA diagnosis (HR 2.3 [1.2-4.3]), and use of proton pump inhibitors (PPIs) after 1 year of age (HR 3.6 [1.1-11.4]). Stunting was significantly associated with genetic anomalies (HR 6.0 [2.8-12.8]), multiple pregnancies (HR 2.4 [1.1-5.6]), gastrostomy (HR 2.3 [1.3-3.8]), and the use of PPI after 1 year (HR 7.8 [2.4-26.1]).
CONCLUSIONS: Despite advances in care, children with EA remain at high risk of undernutrition and stunting from birth to age 16 years. Intensification of nutritional follow-up and early intervention are needed in high-risk patients.
METHODS: We longitudinally studied 204 children born with EA (91% with tracheoesophageal fistula) from birth to 16 years. Undernutrition (Z-score for body mass index [BMI] < -2 SD), and stunting (Z-score for height for age [HFA] < -2 SD) were evaluated. Risk factors were analyzed using regression models for interval-censored data.
RESULTS: The mean Z-BMI and Z-HFA were lower in children with EA than the normal population from birth to age 16 years. At 12 years, the Z-BMI had increased closer to the normal range, but the Z-HFA still differed from the normal range. The cumulative incidence of wasting was 7% (95% CI, 5-12) among 1-year-olds with EA and 25% (95% CI, 19-31) of this population were undernourished at least once between ages 1 and 16 years. Undernutrition was significantly associated with congenital heart malformation (hazard ratio [HR] 2.7 [1.5-5.1]), prenatal EA diagnosis (HR 2.3 [1.2-4.3]), and use of proton pump inhibitors (PPIs) after 1 year of age (HR 3.6 [1.1-11.4]). Stunting was significantly associated with genetic anomalies (HR 6.0 [2.8-12.8]), multiple pregnancies (HR 2.4 [1.1-5.6]), gastrostomy (HR 2.3 [1.3-3.8]), and the use of PPI after 1 year (HR 7.8 [2.4-26.1]).
CONCLUSIONS: Despite advances in care, children with EA remain at high risk of undernutrition and stunting from birth to age 16 years. Intensification of nutritional follow-up and early intervention are needed in high-risk patients.