Body composition and cognition in preschool-age children with congenital gastrointestinal anomalies

Plummer, Erin A.; Wang, Qi; Larson‐Nath, Catherine; Scheurer, Johannah; Ramel, Sara E.

doi:10.1016/j.earlhumdev.2018.12.001

Cited by 12 publications

(13 citation statements)

References 55 publications

(63 reference statements)

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“…Early stress and inadequate nutrition in infancy are linked to altered growth patterns (66, 67) and later neurodevelopmental delays (68, 69). It was shown that children with congenital gastrointestinal anomalies have similar growth and body composition to their peers (70). However, like pre-term-born children (71, 72), higher fat-free mass (but not fat mass) later in life is associated with higher cognitive test scores in children with congenital gastrointestinal anomalies (70).…”

Section: Discussionmentioning

confidence: 99%

“…It was shown that children with congenital gastrointestinal anomalies have similar growth and body composition to their peers (70). However, like pre-term-born children (71, 72), higher fat-free mass (but not fat mass) later in life is associated with higher cognitive test scores in children with congenital gastrointestinal anomalies (70). Authors in the latter study concluded that closer tracking of body composition and interventions aimed at increasing fat-free mass may improve long-term outcomes in this population.…”

Section: Discussionmentioning

confidence: 99%

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Infant Brain Structural MRI Analysis in the Context of Thoracic Non-cardiac Surgery and Critical Care

et al. 2019

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Objective: To determine brain magnetic resonance imaging (MRI) measures of cerebrospinal fluid (CSF) and whole brain volume of full-term and premature infants following surgical treatment for thoracic non-cardiac congenital anomalies requiring critical care. Methods: Full-term ( n = 13) and pre-term ( n = 13) patients with long-gap esophageal atresia, and full-term naïve controls ( n = 19) < 1 year corrected age, underwent non-sedated brain MRI following completion of thoracic non-cardiac surgery and critical care treatment. Qualitative MRI findings were reviewed and reported by a pediatric neuroradiologist and neurologist. Several linear brain metrics were measured using structural T1-weighted images, while T2-weighted images were required for segmentation of total CSF and whole brain tissue using the M orphologically A daptive N eonatal T issue S egmentation ( MANTiS ) tool. Group differences in absolute (mm, cm 3 ) and normalized (%) data were analyzed using a univariate general linear model with age at scan as a covariate. Mean normalized values were assessed using one-way ANOVA. Results: Qualitative brain findings suggest brain atrophy in both full-term and pre-term patients. Both linear and volumetric MRI analyses confirmed significantly greater total CSF and extra-axial space, and decreased whole brain size in both full-term and pre-term patients compared to naïve controls. Although linear analysis suggests greater ventricular volumes in all patients, volumetric analysis showed that normalized ventricular volumes were higher only in premature patients compared to controls. Discussion: Linear brain metrics paralleled volumetric MRI analysis of total CSF and extra-axial space, but not ventricular size. Full-term infants appear to demonstrate similar brain vulnerability in the context of life-saving thoracic non-cardiac surgery requiring critical care as premature infants.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Infant Brain Structural MRI Analysis in the Context of Thoracic Non-cardiac Surgery and Critical Care

et al. 2019

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“…16,28 In a study by Plummer et al, in preschool age children with congenital GI anomalies, a greater amount of fat-free mass was associated with higher test scores. 10 However, there are concerns that early and rapid catch-up growth, particularly in premature infants and infants with intrauterine growth restriction, may increase the risk for later obesity and associated metabolic complications. 29 We recognize our study's limitations.…”

Section: Discussionmentioning

confidence: 99%

“…However, these infants are at high risk for growth failure. [1][2][3][4][5][6][7][8][9][10] These infants have prolonged stays in the neonatal intensive care unit due to feeding intolerance, intestinal surgeries, necrotizing enterocolitis, and sepsis. Moreover, these infants are often born prematurely and at risk for intestinal failure.…”

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confidence: 99%

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Growth from Birth to 30 months for Infants Born with Congenital Gastrointestinal Anomalies and Disorders

et al. 2020

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Objective This study aimed to investigate growth among neonates with gastrointestinal disorders. Study Design Inclusion criteria included neonates with gastroschisis, omphalocele, intestinal atresia, tracheoesophageal fistula, Hirschsprung's disease, malabsorption disorders, congenital diaphragmatic hernia, and imperforate anus born between 2010 and 2018. Anthropometrics were collected for the first 30 months, and a subgroup analysis was performed for gastroschisis infants. Results In 61 subjects, 13% developed severe growth failure within the first month. One-, four-, and nine-month weight and length z-scores were less than birth weight in all infants (p < 0.05). In infants with gastroschisis, a similar pattern was observed for weight z-scores only (p < 0.05). From birth to 15 months, head circumference z-score increased over time in all infants (p = 0.001), while in gastroschisis infants, weight, length, and head circumference z-scores increased over time (p < 0.05). Conclusion In a cohort of infants with gastrointestinal disorders, growth failure was followed by catch-up growth.

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Association between consensus‐based nutrition pathway and growth faltering in infants with gastroschisis: A retrospective cohort study

Strobel,

Kramer,

Rottkamp

et al. 2024

J Parenter Enteral Nutr

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BackgroundThe University of California Fetal Consortium published that 55% of infants with gastroschisis develop growth faltering by hospital discharge. To address this problem, we developed a nutrition pathway emphasizing (1) early provision of parenteral macronutrients, (2) use of human milk, and (3) growth faltering treatment. This study's goals were to assess adherence to and efficacy of this pathway in infants with gastroschisis across six California hospitals.MethodsIn 2015, the consortium standardized the care for infants with gastroschisis. To decrease growth faltering rates, between 2019 and 2020, nutrition guidelines were proposed, discussed, revised, and initiated. This study's primary outcome was weight or linear growth faltering (z score decline ≥0.8 in weight or length) at hospital discharge. Adherence measures were assessed.ResultsOne hundred twenty‐six infants with gastroschisis were born prepathway; 52 were born postpathway. Median gestational age was similar between cohorts. Adherence to components of the pathway ranged from 58% to 95%. The proportion of infants with weight or linear growth faltering at discharge was lower after pathway initiation (59.4% vs 36.2%, P = 0.0068). Adjusting for gestational age and fetal growth restriction, the pathway was associated with decreased weight or linear growth faltering (odds ratio [OR] 0.35 [0.16–0.75], P = 0.0060) and decreased linear growth faltering (OR 0.24 [0.096–0.56], P = 0.0062) at discharge. Hypertriglyceridemia, cholestasis, and days to full feeds were similar to published cohorts.ConclusionFewer infants with gastroschisis experienced weight or length growth faltering at hospital discharge following the implementation of a multicenter nutrition pathway.

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Body composition and cognition in preschool-age children with congenital gastrointestinal anomalies

Cited by 12 publications

References 55 publications

Infant Brain Structural MRI Analysis in the Context of Thoracic Non-cardiac Surgery and Critical Care

Infant Brain Structural MRI Analysis in the Context of Thoracic Non-cardiac Surgery and Critical Care

Growth from Birth to 30 months for Infants Born with Congenital Gastrointestinal Anomalies and Disorders

Association between consensus‐based nutrition pathway and growth faltering in infants with gastroschisis: A retrospective cohort study

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