Outcome of Very Low and Low Birth Weight Infants with Esophageal Atresia: Results of the Turkish Esophageal Atresia Registry

Abstract Introduction The data of the Turkish Esophageal Atresia Registry (TEAR) was evaluated to define the outcome of very low birth weight (VLBW) and low BW (LWB) infants with esophageal atresia (EA). Materials and Methods The data registered by 24 centers between 2014 and 2018 were evaluated for demographic features, prenatal findings, associated anomalies, surgical treatment, and outcome. Patients were enrolled in three groups according to their BWs (VLBW <1,500 g), LWB = 1,500–2,500 g), and normal BW (NBW; >2,500 g). Results Among the 389 cases, there were 37 patients (9.5%) in the VLBW group, 165 patients (42.4%) in the LBW group, and 187 patients (48.1%) in the NBW group. Prenatal diagnosis rates were similar among the three groups (29.7, 34.5, and 24.6%, respectively). The standard primary anastomosis was achieved at a significantly higher rate in NWB cases than in the other groups (p < 0.05). In patients with tracheoesophageal fistula (TEF), patients of the NBW group had significantly higher rates of full oral feedings, when compared with VLBW and LBW cases (p < 0.05). At the end of the first year, when we evaluate all patients, the number of cases with fistula recanalization and esophageal anastomotic strictures (AS) requiring esophageal dilatation was similar among the groups. The weight and height measurements at 6 months and 1 year of age of the survivors were similar in all the groups. The overall mortality rate was significantly higher in the VLBW and LBW groups, when compared with the NBW patients, even in patients with tension-free anastomosis (p < 0.05). The incidence of the associated anomalies was 90.6% in cases with mortality, which was significantly higher than in survivors (59.6%; p < 0.05). According to Spitz's classification, the survival rate was 87.1% in class I, 55.3% in class II, and 16.7% in class III. The most common causes of mortality were associated with cardiovascular diseases, pneumonia, and sepsis. Conclusion The national data of TEAR demonstrates that the developmental and feeding parameters are better in NBW patients. Although VLBW patients have higher risk of developing fistula canalization than the LBW and NBW groups, long-term complications, such as anastomotic strictures, weight, and height values, after 1 year are similar in both groups. According to our results, associated anomalies and LBWs are still significant risk factors for mortality in cases with EA.

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Outcome of primary repair in extremely and very low-birth-weight infants with esophageal atresia/distal tracheoesophageal fistula

Journal of Pediatric Surgery ◽

10.1016/j.jpedsurg.2017.05.011 ◽

2017 ◽

Vol 52 (10) ◽

pp. 1567-1570 ◽

Cited By ~ 8

Author(s):

Andreas Schmidt ◽

Florian Obermayr ◽

Justus Lieber ◽

Christian Gille ◽

Frank Fideler ◽

...

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Esophageal Atresia ◽

Tracheoesophageal Fistula ◽

Very Low Birth Weight ◽

Primary Repair ◽

Low Birth Weight Infants

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Fatores de Risco para Sépsis Associada aos Cuidados de Saúde em Recém-nascidos de Muito Baixo Peso

Acta Médica Portuguesa ◽

10.20344/amp.6839 ◽

2016 ◽

Vol 29 (4) ◽

pp. 261 ◽

Cited By ~ 1

Author(s):

Helena Pereira ◽

Ema Grilo ◽

Patrícia Cardoso ◽

Natália Noronha ◽

Cristina Resende

Keyword(s):

Risk Factors ◽

Birth Weight ◽

Low Birth Weight ◽

Parenteral Nutrition ◽

Gestational Age ◽

Very Low Birth Weight ◽

Significant Risk ◽

Low Birth Weight Infants ◽

Average Birth Weight ◽

Healthcare Associated

Introduction: Healthcare associated infections in very low birth weight infants are associated with significant morbidity and mortality and are also a cause of increased length of stay and hospital costs. The objective of this study was to evaluate the rate of healthcare-associated sepsis and associated risk factors in very low birth weight infants. Material and Methods: Retrospective observational study including very low birth weight infants hospitalized in a Neonatal Intensive Care Unit during ten years (2005-2014). We evaluated the association between several risk factors and healthcare-associated sepsis. Results: 461 very low birth weight infants were admitted. There were 110 episodes of HS in 104 very low birth weight infants and 53 episodes of sepsis associated with central vascular catheter. The density of the sepsis was 7.5/1 000 days of hospitalization and the density of central vascular catheter - associated sepsis was 22.6/1 000 days of use. The infants with HS had lower average birth weight and gestational age (959 ± 228 g vs 1191 ± 249 g and 27.6 ± 2 vs 29.8 ± 2.2 weeks), p < 0.001. After adjusting for birth weight and gestational age we verified an association between healthcare-associated sepsis and antibiotic therapy in D1, the duration of parenteral nutrition and central vascular catheter. After logistic regression only the gestational age and duration of parenteral nutrition remained as independent significant risk factors for healthcare-associated sepsis. Discussion: The independent factors for healthcare-associated sepsis are gestational age and duration of parenteral nutrition. Conclusion: For each extra week on gestational age the risk declined in 20% and for each day of NP the risk increased 22%.

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Impact of Different Types of Nosocomial Infection on the Neurodevelopmental Outcome of Very Low Birth Weight Infants

Children ◽

10.3390/children8030207 ◽

2021 ◽

Vol 8 (3) ◽

pp. 207

Author(s):

Karin Pichler ◽

Vito Giordano ◽

Gereon Tropf ◽

Renate Fuiko ◽

Angelika Berger ◽

...

Keyword(s):

Risk Factor ◽

Birth Weight ◽

Low Birth Weight ◽

Very Low Birth Weight ◽

Neurodevelopmental Outcome ◽

Significant Risk ◽

Significant Risk Factor ◽

Low Birth Weight Infants ◽

Neurodevelopmental Outcomes ◽

The Impact

Nosocomial infections (NIs) are important conditions associated with mortality and morbidity in very low birth weight infants (VLBWIs). The aim of this study was to investigate the impact of NIs and the different subtypes on neurodevelopmental outcomes in a cohort of VLBWIs. VLBWIs born with a gestational age between 23 0/7 and 31 6/7 weeks in a level III neonatal center were enrolled. Neonatal morbidities as well as the neurodevelopmental outcome at 2 years of corrected age were analyzed. Six-hundred infants completed the study successfully. Of these, 38% experienced an NI episode. NIs were associated with an increased risk of neonatal complications, such as brain injury, bronchopulmonary dysplasia (BPD) and death, and were a significant risk factor for adverse motor development at 2 years of corrected age in our cohort of VLBWIs. The negative impact of NIs on neurodevelopmental outcomes was particularly associated with necrotizing enterocolitis (NEC), suspected NIs and Gram-positive NIs. This study demonstrated that NIs are a significant risk factor for both morbidity and mortality as well as adverse neurodevelopmental outcomes in VLBWIs.

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Changes in Biochemical Parameters of the Calcium-Phosphorus Homeostasis in Relation to Nutritional Intake in Very-Low-Birth-Weight Infants

10.20944/preprints201611.0129.v1 ◽

2016 ◽

Author(s):

Viola Christmann ◽

Charlotte J. W. Gradussen ◽

Michelle N. Körnmann ◽

Nel Roeleveld ◽

Johannes B. Van Goudoever ◽

...

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Gestational Age ◽

Biochemical Parameters ◽

Mixed Model ◽

Very Low Birth Weight ◽

Significant Risk ◽

Repeated Measurements ◽

Nutritional Intake ◽

Low Birth Weight Infants

Preterm infants are at significant risk to develop reduced bone mineralization based on inadequate supply of calcium and phosphorus (Ca-P). Biochemical parameters can be used to evaluate the nutritional intake. The direct effect of nutritional intake on changes in biochemical parameters has not been studied. Our objective was to evaluate the effect of Ca-P supplementation on biochemical markers as serum (s)/urinary (u) Ca and P; alkaline phosphatase (ALP); tubular reabsorption of P (TrP) and urinary ratios for Ca/creatinin and P/creatinin in Very-Low-Birth-Weight infants on postnatal day 1, 3, 5, 7, 10, and 14. This observational study compared two groups with High (n = 30) and Low (n = 40) intake of Ca-P. Birth weight: median (IRQ) 948 (772-1225) vs. 939 (776-1163) grams; Gestational age: 28.2 (26.5-29.6) vs. 27.8 (26.1-29.4) weeks. Daily median concentrations of biochemical parameter were not different between the groups but linear regression mixed model analyses showed that Ca intake increased the uCa and TrP (p = 0.04) and decreased ALP (p = 0.00). Phosphorus intake increased sP, uP and uP/creat ratio and ALP (p ≤ 0.02) and caused decrease in TrP (p = 0.00). Protein intake decreased sP (p = 0.000), while low gestational age and male gender increased renal excretion of P (p < 0.03). Standardized repeated measurements showed that biochemical parameters were affected by nutritional intake, gestational age and gender.

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DOZ047.11: Survival rates of infants with esophageal atresia: data of Turkish Esophageal Atresia Registry

Diseases of the Esophagus ◽

10.1093/dote/doz047.11 ◽

2019 ◽

Vol 32 (Supplement_1) ◽

Author(s):

M O Öztan ◽

T Soyer ◽

C I Öztorun ◽

B Fırıncı ◽

Ç U Durakbaşa ◽

...

Keyword(s):

Risk Factors ◽

Survival Rate ◽

Esophageal Atresia ◽

Primary Anastomosis ◽

Survival Rates ◽

Tube Feeding ◽

Significant Risk ◽

Class Iii ◽

Associated Anomalies ◽

Female Ratio

Abstract Aim The data of the Turkish Esophageal Atresia Registry (TEAR) was evaluated to define the survival rate and risk factors of mortality in infants with esophageal atresia (EA). Methods The data of 389 cases registered by 23 centers between 2014 and 2018 were evaluated for demographic features, associated anomalies, surgical treatment and mortality-related outcome. Each parameter was evaluated for cases with mortality (CM) and compared with the results of survivors. Also, prognostic factors were investigated in CM. Results The overall survival rate was 81.09% and the mortality was 19.02% (n = 74). The male/female ratio was 1:1 in CM and 1.2:1 in survivors. The mean weight and height measurements in CM were lower than in survivors (1956 ± 658 g- 43.2 ± 5.7 cm vs 2534 ± 609 g-46.4 ± 4.3 cm) (P < 0.05). The incidence of associated anomalies was 90.6% in CM and significantly higher than survivors (59.6%) (P < 0.05). Neurological, cardiovascular, vertebral, and extremity anomalies were significantly higher in CM (P < 0.001). The most common type of anomaly was EA with distal fistula 89.2% in CM and 74.6% in survivors. The rate of primary anastomosis was also significantly lower in CM (67.6% vs 84.3%, P < 0.05). The gap length did not show statistical difference between CM and survivors (P > 0.05). Tube feeding was more common in CM and the incidence of full oral feedings was significantly higher in survivors (P < 0.01). According to the Spitz classification, the survival rate was 87.1% in Class I, 55.3% in Class II, and 16.7% in Class III. The most common causes of mortality were associated with cardiovascular disease, pneumonia, and sepsis. Conclusion The majority of national TEAR data comes from tertiary healthcare centers in Turkey. Therefore, the slightly increased mortality rates could be related to the inclusion of more complex and complicated cases. Birth weight–height, associated anomalies, and Spitz classification are significant risk factors of mortality in cases with EA.

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