Gastrostomy tube placement common among ELBW babies

Infants born extremely low birth weight (ELBW) are likely to require gastrostomy tube (GT) placement, especially those with severe neonatal morbidities, a recent study has found.

A total of 4,549 ELBW infants (mean gestational age, 25.73±1.30 weeks; 49 percent male) were included in the present analysis. Accessing the databases and follow-up registries of 25 medical participating centres, researchers obtained the information about long-term outcomes and GT placement before 18–22 months of age.

Majority of the participants did not have GTs (n=4,216); only 333 infants required placement. The resulting prevalence rate was 7.3 percent. The latter group was significantly more likely to develop adverse long-term outcomes, such as breathing and feeding problems, moderate or severe cerebral palsy, and neurodevelopmental impairments (p-all<0.01).

Logistic regression analysis was then performed to identify characteristic variables associated with an increased likelihood of GT placement. Small for gestational age (odds ratio [OR], 1.92, 95 percent CI, 1.31–2.84; p<0.01) and length of hospital stay (OR, 1.02, 1.02–1.02; p<0.01) emerged as significant risk factors.

The same was true for having chronic breathing (OR, 2.42, 1.89–3.10; p<0.01) and feeding (OR, 4.06, 3.12–5.28; p<0.01), as well as moderate or severe cerebral palsy (OR, 4.60, 3.25–6.50; p<0.01). Necrotizing enterocolitis, on the other hand, did not emerge as a significant risk factor (OR, 1.13, 0.70–1.81; p=0.61).

The present findings highlight the need for stricter nutritional follow-up of ELBW infants, said researchers. Future studies are needed to better understand the optimal timing of GT placement and for the standardization of oral infant feeding guidelines.