BACKGROUND: Gastrostomy tube (G-tube) placement is a long-term alternative to oral or nasogastric feeding for premature infants who cannot safely feed orally or need supplemental nutrition for adequate growth. METHODS: We compared daily weight changes for G-tube infants 14 and 30 days preplacement and postplacement, excluding the first 7 days post-G-tube insertion. Infants <37 weeks of gestation without major congenital anomalies and discharged from 327 United States neonatal intensive care units (2004-2013) were included. Incidence of in-hospital outcomes including hypoxic ischemic encephalopathy, intraventricular hemorrhage grade 3 or 4, necrotizing enterocolitis, and patent ductus arteriosus ligation was examined. Additionally, we estimated a treatment effect model in which infants with a G-tube were matched 1:1 to untreated controls based on propensity scores; main outcome was the average treatment effect (weight gain) for treated infants during the 7, 14, or 30 days immediately prior to discharge. RESULTS: Of 329,254 infants, 1393 (0.4%) received a G-tube, increasing from 0.2% in 2004 to 0.6% in 2013. Daily weight gain was significantly less during days 8-14 postplacement compared with 14 days preplacement but was similar between 30 days preplacement and 8-30 days postplacement. After matching, G-tube infant weight gain during the 7 days predischarge was less than among controls, but there was no difference in weight gain between treated and control patients for 14 days and 30 days predischarge. CONCLUSIONS: The prevalence of G-tube placement has increased. G-tube use in infants was not associated with improved short-term daily weight gain.
BACKGROUND: Gastrostomy tube (G-tube) placement is a long-term alternative to oral or nasogastric feeding for premature infants who cannot safely feed orally or need supplemental nutrition for adequate growth. METHODS: We compared daily weight changes for G-tube infants 14 and 30 days preplacement and postplacement, excluding the first 7 days post-G-tube insertion. Infants <37 weeks of gestation without major congenital anomalies and discharged from 327 United States neonatal intensive care units (2004-2013) were included. Incidence of in-hospital outcomes including hypoxic ischemic encephalopathy, intraventricular hemorrhage grade 3 or 4, necrotizing enterocolitis, and patent ductus arteriosus ligation was examined. Additionally, we estimated a treatment effect model in which infants with a G-tube were matched 1:1 to untreated controls based on propensity scores; main outcome was the average treatment effect (weight gain) for treated infants during the 7, 14, or 30 days immediately prior to discharge. RESULTS: Of 329,254 infants, 1393 (0.4%) received a G-tube, increasing from 0.2% in 2004 to 0.6% in 2013. Daily weight gain was significantly less during days 8-14 postplacement compared with 14 days preplacement but was similar between 30 days preplacement and 8-30 days postplacement. After matching, G-tube infant weight gain during the 7 days predischarge was less than among controls, but there was no difference in weight gain between treated and control patients for 14 days and 30 days predischarge. CONCLUSIONS: The prevalence of G-tube placement has increased. G-tube use in infants was not associated with improved short-term daily weight gain.
Authors: Maureen A Lefton-Greif; Thomas O Crawford; Sharon McGrath-Morrow; Kathryn A Carson; Howard M Lederman Journal: Orphanet J Rare Dis Date: 2011-05-15 Impact factor: 4.123
Authors: Hyder Al-Attar; Arvind K Shergill; Nicole E Brown; Cindy Guernsey; David Fisher; Michael Temple; Philip John; Joao G Amaral; Dimitri Parra; Bairbre L Connolly Journal: Pediatr Radiol Date: 2011-12-01
Authors: John E Fortunato; April L Troy; Carmen Cuffari; J Erin Davis; Matthew J Loza; Maria Oliva-Hemker; Kathleen B Schwarz Journal: J Pediatr Gastroenterol Nutr Date: 2010-04 Impact factor: 2.839
Authors: Andrea Trembath; Christoph P Hornik; Reese Clark; P Brian Smith; Julie Daniels; Matthew Laughon Journal: J Pediatr Date: 2013-06-12 Impact factor: 4.406
Authors: Sharmistha Rudra; Obinna O Adibe; William F Malcolm; P Brian Smith; C Michael Cotten; Rachel G Greenberg Journal: Early Hum Dev Date: 2016-08-22 Impact factor: 2.699