Baldassarre Maria Elisabetta, Di Mauro Antonio, Salvatore Silvia, Tafuri Silvio, Bianchi Francesco Paolo, Dattoli Enzo, Morando Lucia, Pensabene Licia, Meneghin Fabio, Dilillo Dario, Mancini Valentina, Talarico Valentina, Tandoi Francesco, Zuccotti Gianvincenzo, Agosti Massimo, Laforgia Nicola
Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari, Bari, Italy.
Unit of Pediatrics and Neonatology, "F. Del Ponte" Hospital, Dipartimento di Medicina e Chirurgia University of Insubria, Varese, Italy.
Pediatr Gastroenterol Hepatol Nutr. 2020 Jul;23(4):366-376. doi: 10.5223/pghn.2020.23.4.366. Epub 2020 Jul 3.
To assess the association between birth weight and the development of functional gastrointestinal disorders (FGIDs) in the first year of life.
This is a secondary analysis of a prospective cohort multicenter study including neonates, consecutively enrolled at birth, and followed up for one year. At birth all infants were classified by birth weight as extremely low (ELBW), very low, or low when <1,000, <1,500, and <2,500 g, respectively, and by birth weight for gestational age as appropriate (AGA, weight in the 10-90th percentile), small (SGA, weight <10th percentile), and large (LGA, weight >90th percentile) for gestational age. FGIDs were classified according to the Rome III criteria and assessed at 1, 3, 6, and 12 months of life.
Among 1,152 newborns enrolled, 934 (81.1%) completed the study: 302 (32.3%) were preterm, 35 (3.7%) were ELBW, 104 (11.1%) were SGA, 782 (83.7%) were AGA, and 48 (5.1%) were LGA infants. Overall, throughout the first year of life, 718 (76.9%) reported at least one FGID. The proportion of infants presenting with at least one FGID was significantly higher in ELBW (97%) compared to LBW (74%) (=0.01) and in LGA (85.4%) and SGA (85.6%) compared to AGA (75.2%) (=0.0001). On multivariate analysis, SGA was significantly associated with infantile colic.
We observed an increased risk of FGIDs in ELBW, SGA, and LGA neonates. Our results suggest that prenatal factors determining birth weight may influence the development of FGIDs in infants. Understanding the role of all potential risk factors may provide new insights and targeted approaches for FGIDs.
评估出生体重与出生后第一年功能性胃肠疾病(FGIDs)发生之间的关联。
这是一项对前瞻性队列多中心研究的二次分析,研究对象为出生时连续入组并随访一年的新生儿。出生时,所有婴儿根据出生体重分为极低出生体重(ELBW,<1000g)、低出生体重(<1500g)或正常出生体重(<2500g),并根据胎龄对应的出生体重分为适于胎龄儿(AGA,体重在第10至90百分位数)、小于胎龄儿(SGA,体重<第10百分位数)和大于胎龄儿(LGA,体重>第90百分位数)。FGIDs根据罗马III标准进行分类,并在出生后1、3、6和12个月进行评估。
在1152名入组的新生儿中,934名(81.1%)完成了研究:302名(32.3%)为早产儿,35名(3.7%)为ELBW,104名(11.1%)为SGA,782名(83.7%)为AGA,48名(5.1%)为LGA婴儿。总体而言,在出生后的第一年,718名(76.9%)报告至少患有一种FGID。与低出生体重儿(74%)相比,ELBW婴儿中至少患有一种FGID的比例显著更高(97%)(P=0.01);与AGA婴儿(75.2%)相比,LGA(85.4%)和SGA(85.6%)婴儿中至少患有一种FGID的比例也显著更高(P=0.0001)。多因素分析显示,SGA与婴儿腹绞痛显著相关。
我们观察到ELBW、SGA和LGA新生儿患FGIDs的风险增加。我们的结果表明,决定出生体重的产前因素可能会影响婴儿FGIDs的发生。了解所有潜在风险因素的作用可能为FGIDs提供新的见解和针对性的治疗方法。