Article Text

MODERATE TO SEVERE BRONCHOPULMONARY DYSPLASIA AND GASTROESOPHAGEAL REFLUX IN INFANTS WITH BIRTH WEIGHT ⩽1250 G
  1. F Hermeto1,
  2. V Mahajan1,
  3. M Bottino1,
  4. G M Sant’Anna1
  1. 1Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada

Abstract

Background There are few data on the association between bronchopulmonary dysplasia (BPD) and gastroesophageal reflux (GER). Nevertheless, infants with BPD are often diagnosed and treated for GER.

Objective To determine the characteristics, incidence and management of GER among infants with moderate to severe BPD.

Methods From January 2003 to December 2006 medical records of all babies with birth weight ⩽1250 g and moderate to severe BPD were reviewed. Data were collected using a predefined form. Descriptive statistics and t tests were used.

Results Sixty-four infants were identified and 32 (50%) were diagnosed with GER. They were managed with prolonged or continuous feeds (100%), thickened feeds (19%) and/or antireflux drugs (59%). One infant (3%) had a pH probe study. Antireflux drugs were started at 76 ± 38 days (mean ± SD) and 28% of the infants were discharged home on drug therapy. Gastrostomy was performed in four (12.5%) infants out of whom two had fundoplication. There was no difference in birth weight, gender, antenatal steroids and intraventricular haemorrhage among the two groups (GER vs no GER). However, infants with clinical GER had lower gestational age (p<0.05), prolonged hospital stay (p<0.01), higher incidence of severe BPD (p<0.05) and necrotising enterocolitis (p = 0.01) compared with infants without suspected GER.

Conclusion GER was commonly diagnosed in infants with moderate to severe BPD without specific evaluation. These infants were frequently submitted to pharmacological treatment and its potential side effects without strong evidence of benefit. The diagnosis of GER and safety of antireflux drugs needs to be better established before routine therapeutic interventions are instituted.

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