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JPEN J Parenter Enteral Nutr. 2020 Feb;44(2):355-360. doi: 10.1002/jpen.1539. Epub 2019 Mar 25.

Impact of Gastrostomy Tube Placement on Short-Term Weight Gain in Hospitalized Premature Infants.

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Department of Pediatrics, University of Washington, Seattle, Washington, USA.
Department of Pediatrics, Duke University Medical Center, Durham, North Carolina, USA.
Department of Economics, Clemson University, Clemson, South Carolina, USA.
Duke Clinical Research Institute, Durham, North Carolina, USA.
Pediatrix-Obstetrix Center for Research and Education, Sunrise, Florida, USA.



Gastrostomy tube (G-tube) placement is a long-term alternative to oral or nasogastric feeding for premature infants who cannot safely feed orally or need supplemental nutrition for adequate growth.


We compared daily weight changes for G-tube infants 14 and 30 days preplacement and postplacement, excluding the first 7 days post-G-tube insertion. Infants <37 weeks of gestation without major congenital anomalies and discharged from 327 United States neonatal intensive care units (2004-2013) were included. Incidence of in-hospital outcomes including hypoxic ischemic encephalopathy, intraventricular hemorrhage grade 3 or 4, necrotizing enterocolitis, and patent ductus arteriosus ligation was examined. Additionally, we estimated a treatment effect model in which infants with a G-tube were matched 1:1 to untreated controls based on propensity scores; main outcome was the average treatment effect (weight gain) for treated infants during the 7, 14, or 30 days immediately prior to discharge.


Of 329,254 infants, 1393 (0.4%) received a G-tube, increasing from 0.2% in 2004 to 0.6% in 2013. Daily weight gain was significantly less during days 8-14 postplacement compared with 14 days preplacement but was similar between 30 days preplacement and 8-30 days postplacement. After matching, G-tube infant weight gain during the 7 days predischarge was less than among controls, but there was no difference in weight gain between treated and control patients for 14 days and 30 days predischarge.


The prevalence of G-tube placement has increased. G-tube use in infants was not associated with improved short-term daily weight gain.


gastrostomy tube; premature infants; weight gain


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