The Irritable Infant in the Neonatal Intensive Care Unit: Risk Factors and Biomarkers of Gastroesophageal Reflux Disease.
J Pediatr
; 264: 113760, 2024 Jan.
Article
in En
| MEDLINE
| ID: mdl-37777170
ABSTRACT
OBJECTIVES:
To determine risk factors for arching/irritability in high-risk infants and examine the significance of comorbidity and gastroesophageal reflux (GER) characteristics. STUDYDESIGN:
Retrospective analysis of 24-hour pH-impedance studies of symptomatic infants in a neonatal intensive care unit (ICU) (n = 516, 30.1 ± 4.5 weeks of gestation, evaluated at 41.7 ± 3.2 weeks postmenstrual age) was conducted. Comparisons were made between infants with >72 vs ≤72 arching/irritability events per day. We characterized risk factors for arching/irritability along with clinical, pH-impedance, and outcome correlates.RESULTS:
Of 39â973 arching/irritability events and 42â155 GER events, the averages per day were 77.6 ± 41.0 and 81.7 ± 48.2, respectively. Acid reflux and impedance bolus characteristics were not significantly different between infants with >72 and ≤72 arching/irritability events (P ≥ .05). The odds ratios (ORs) and 95% confidence intervals (CIs) adjusted for postmenstrual age and weight at evaluation were significant for risk factors of preterm birth (2.3 [1.2-4.4]), moderate or severe neuropathology (2.0 [1.1-3.6]), and presence of oral feeding at testing (1.57 [1.07-2.30]).CONCLUSIONS:
Acid GER disease is unlikely the primary cause of arching/irritability and empiric treatment should not be used when arching/irritability is present. Prematurity and neurologic impairment may be more likely the cause of the arching/irritability. Arching/irritability may not be a concern in orally fed infants.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Gastroesophageal Reflux
/
Premature Birth
/
Infant, Newborn, Diseases
Type of study:
Etiology_studies
/
Risk_factors_studies
Limits:
Female
/
Humans
/
Infant
/
Newborn
Language:
En
Journal:
J Pediatr
/
J. pediatr. (Rio J.)
/
Jornal de pediatria (Impresso)
Year:
2024
Document type:
Article
Country of publication:
United States