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Predictors of low weight and tube feedings in children with congenital diaphragmatic hernia at 1 year of age.
[congenital diaphragmatic hernia]
Congenital
diaphragmatic
hernia
(
CDH
)
survivors
often
have
gastrointestinal
disorders
,
and
limited
outcome
data
exist
.
This
study
reviewed
risk
factors
for
low
weight
and
use
of
feeding
tubes
after
CDH
repair
at
1
year
of
age
.
The
hypothesis
was
that
patients
who
required
extracorporeal
membrane
oxygenation
(
ECMO
)
or
with
significant
pulmonary
arterial
hypertension
(
PAH
)
would
have
lower
weight
percentiles
and
more
often
require
tube
feedings
.
A
retrospective
chart
review
of
89
infants
with
CDH
diagnosed
in
the
neonatal
period
was
conducted
.
Statistical
analysis
was
performed
using
χ
test
,
Fisher
exact
test
,
and
logistic
regression
.
Seventy
-
two
patients
(
81
%
)
survived
to
1
year
of
age
.
Of
these
patients
,
35
%
were
<
5
th
percentile
for
weight
and
18
%
were
receiving
tube
feedings
.
Both
ECMO
and
PAH
were
associated
with
an
increased
risk
for
requiring
tube
feedings
at
1
year
of
age
,
with
respective
odds
ratios
of
6
.
00
(
P
=
0
.
01
)
and
15
.
75
(
P
=
0
.
02
)
;
however
,
neither
ECMO
nor
PAH
was
associated
with
low
weight
at
1
year
of
age
.
No
statistical
correlation
was
found
between
an
abnormal
pH
probe
and
tube
feedings
at
1
year
of
age
.
Patients
with
CDH
are
at
increased
risk
for
having
a
weight
<
5
th
percentile
at
1
year
of
age
.
A
history
of
ECMO
and
PAH
are
independently
associated
with
an
increased
requirement
for
tube
feedings
at
1
year
of
age
.
Close
nutritional
monitoring
and
counseling
should
be
considered
in
all
of
the
patients
with
CDH
,
particularly
those
with
a
history
of
ECMO
or
PAH
.
Diseases
Validation
Diseases presenting
"neonatal period"
symptom
alexander disease
alpha-thalassemia
benign recurrent intrahepatic cholestasis
congenital adrenal hyperplasia
congenital diaphragmatic hernia
congenital toxoplasmosis
cutaneous mastocytosis
dystrophic epidermolysis bullosa
epidermolysis bullosa simplex
harlequin ichthyosis
hirschsprung disease
homocystinuria without methylmalonic aciduria
junctional epidermolysis bullosa
kabuki syndrome
kallmann syndrome
kindler syndrome
lamellar ichthyosis
megacystis-microcolon-intestinal hypoperistalsis syndrome
monosomy 21
neonatal adrenoleukodystrophy
neuralgic amyotrophy
pyruvate dehydrogenase deficiency
zellweger syndrome
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