Vivek Kumar1, S S Mathai, M Kanitkar. 1. Department of Pediatrics, 12 Air Force Hospital, Gorakhpur, Akash vihar Kunraghat, Uttar Pradesh, India. vk3532@gmail.com
Abstract
OBJECTIVE: To find out the incidence of Gastro-esophageal reflux (GER) in neonates at risk for it and compare this with the incidence in the controls. METHODS: This prospective case control study was conducted on 34 neonates. Twenty-four test high risk neonates comprised of preterms, neonates on mechanical ventilation neonates with ALTE(Acute Life Threatening Episode) and post-operative neonates (Tracheo-esophageal fistula, congenital diaphragmatic hernia). There were ten matched controls. Esophageal pHmetry was done using double sensor antimony pH probe and the two groups were compared. Significant reflux was defined as any reflux on pharyngeal sensor (grade 4 reflux) or a Reflux Index or RI (amount of time the esophageal pH remained <4) >20%.Analysis were done using Fisher Exact t test and Chi square test. RESULTS: Mean gestational age was 34.87(3.86) wk and 33.7(3.29) wk in the test and control groups respectively, while mean BW was 2186.02(814.57) g and 1851.2(592.93) g in each respective group. In the test group 10 were symptomatic, 5 were on mechanical ventilation, 8 were on CPAP and one was post-operation case. Difference in the incidence of significant RI in test and control group was not statistically significant. Incidence between various group of neonates in test group showed no statistical significance either. However, the incidence of grade IV reflux in test group was 8/24 and control 0/10 and this difference was statistically significant. Reflux did increase when period of gestation decreased and the difference was statistically significant. CONCLUSIONS: Clinically significant grade IV GER was more in high risk (test) neonates than control.
OBJECTIVE: To find out the incidence of Gastro-esophageal reflux (GER) in neonates at risk for it and compare this with the incidence in the controls. METHODS: This prospective case control study was conducted on 34 neonates. Twenty-four test high risk neonates comprised of preterms, neonates on mechanical ventilation neonates with ALTE(Acute Life Threatening Episode) and post-operative neonates (Tracheo-esophageal fistula, congenital diaphragmatic hernia). There were ten matched controls. Esophageal pHmetry was done using double sensor antimony pH probe and the two groups were compared. Significant reflux was defined as any reflux on pharyngeal sensor (grade 4 reflux) or a Reflux Index or RI (amount of time the esophageal pH remained <4) >20%.Analysis were done using Fisher Exact t test and Chi square test. RESULTS: Mean gestational age was 34.87(3.86) wk and 33.7(3.29) wk in the test and control groups respectively, while mean BW was 2186.02(814.57) g and 1851.2(592.93) g in each respective group. In the test group 10 were symptomatic, 5 were on mechanical ventilation, 8 were on CPAP and one was post-operation case. Difference in the incidence of significant RI in test and control group was not statistically significant. Incidence between various group of neonates in test group showed no statistical significance either. However, the incidence of grade IV reflux in test group was 8/24 and control 0/10 and this difference was statistically significant. Reflux did increase when period of gestation decreased and the difference was statistically significant. CONCLUSIONS: Clinically significant grade IV GER was more in high risk (test) neonates than control.