Fellow Emory University School of Medicine Atlanta, Georgia, United States
Background: Gastroschisis is a leading cause of intestinal failure and inadequate somatic weight gain. Infants with gastroschisis are often small for gestational age and optimal nutritional management strategies for these infants are lacking and contribute to poor growth outcomes. There have been no large, multicenter studies addressing growth failure rates among infants with gastroschisis and how feeding practices impact this outcome. Objective: To describe the incidence and degree of growth failure among hospitalized infants with gastroschisis. To describe feeding and nutrition practices across level IV neonatal intensive care units (NICUs) in the Children’s Hospitals Neonatal Consortium (CHNC). Design/Methods: This is a multicenter, retrospective cohort study of infants with gastroschisis admitted to participating CHNC level IV NICUs identified from the Children’s Hospitals Neonatal Database (CHND) between January 2017 and December 2022. IRBs were established at each center and DUAs were obtained as applicable. Demographic data, complications, growth parameters, and feeding and nutrition details included in the CHND were collected. Z-scores were calculated for weight, head circumference, and length. The degree of malnutrition was defined based on the decline in z-score from birth to discharge: mild (decline of 0.8-1.2 SD), moderate (decline of >1.2-2 SD), or severe (decline of >2 SD). Additional sub-group analysis is planned: those who are small for gestational age vs. appropriate for gestational age; those who are premature vs. late preterm vs. term; those with complex gastroschisis vs. simple gastroschisis. To date, we have preliminary data from 648 patients across 6 centers. We are completing data collection and plan to start statistical analysis shortly.
