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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.

Author information

1
Department of Pediatrics, University of Washington, Seattle, Washington, USA.
2
Department of Pediatrics, Duke University Medical Center, Durham, North Carolina, USA.
3
Department of Economics, Clemson University, Clemson, South Carolina, USA.
4
Duke Clinical Research Institute, Durham, North Carolina, USA.
5
Pediatrix-Obstetrix Center for Research and Education, Sunrise, Florida, USA.

Abstract

BACKGROUND:

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.

METHODS:

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.

RESULTS:

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.

CONCLUSIONS:

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

KEYWORDS:

gastrostomy tube; premature infants; weight gain

PMID:
30908714
DOI:
10.1002/jpen.1539

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