Depoortere Suzanne, Lapillonne Alexandre, Sfeir Rony, Bonnard Arnaud, Gelas Thomas, Panait Nicoleta, Rabattu Pierre-Yves, Guignot Audrey, Lamireau Thierry, Irtan Sabine, Habonimana Edouard, Breton Anne, Fouquet Virginie, Allal Hossein, Elbaz Frédéric, Talon Isabelle, Ranke Aline, Abely Michel, Michel Jean-Luc, Lirussi Borgnon Joséphine, Buisson Philippe, Schmitt Françoise, Lardy Hubert, Petit Thierry, Chaussy Yann, Borderon Corinne, Levard Guillaume, Cremillieux Clara, Tolg Cécilia, Breaud Jean, Jaby Olivier, Grossos Céline, De Vries Philine, Arnould Myriam, Pelatan Cécile, Geiss Stephan, Laplace Christophe, Kyheng Maéva, Nicolas Audrey, Aumar Madeleine, Gottrand Frédéric
Univ. Lille, CRACMO Reference Center for Rare Esophageal Diseases, CHU Lille, INFINITE U1286, Lille, France.
University Hospital APHP Necker-Enfants Malades, Paris, France.
Front Pediatr. 2022 Aug 4;10:969617. doi: 10.3389/fped.2022.969617. eCollection 2022.
Despite recent progress in caring for patients born with esophageal atresia (EA), undernutrition and stunting remain common. Our study objective was to assess nutritional status in the first year after birth with EA and to identify factors associated with growth failure.
We conducted a population-based study of all infants born in France with EA between 2010 and 2016. Through the national EA register, we collected prenatal to 1 year follow-up data. We used body mass index and length-for-age ratio Z scores to define patients who were undernourished and stunted, respectively. Factors with < 0.20 in univariate analyses were retained in a logistic regression model.
Among 1,154 patients born with EA, body mass index and length-for-age ratio Z scores at 1 year were available for about 61%. Among these, 15.2% were undernourished and 19% were stunted at the age of 1 year. There was no significant catch-up between ages 6 months and 1 year. Patients born preterm (41%), small for gestational age (17%), or with associated abnormalities (55%) were at higher risk of undernutrition and stunting at age 1 year ( < 0.05). Neither EA type nor surgical treatment was associated with growth failure.
Undernutrition and stunting are common during the first year after birth in patients born with EA. These outcomes are significantly influenced by early factors, regardless of EA type or surgical management. Identifying high-risk patient groups with EA (i.e., those born preterm, small for gestational age, and/or with associated abnormalities) may guide early nutritional support strategies.
尽管在食管闭锁（EA）患儿的护理方面最近取得了进展，但营养不良和发育迟缓仍然很常见。我们的研究目的是评估EA患儿出生后第一年的营养状况，并确定与生长发育不良相关的因素。
我们对2010年至2016年在法国出生的所有EA患儿进行了一项基于人群的研究。通过国家EA登记处，我们收集了从产前到1岁的随访数据。我们分别使用体重指数和年龄别身长比Z评分来定义营养不良和发育迟缓的患者。单因素分析中P<0.20的因素被纳入逻辑回归模型。
在1154例EA患儿中，约61%有1岁时的体重指数和年龄别身长比Z评分数据。其中，15.2%在1岁时营养不良，19%发育迟缓。6个月至1岁之间没有明显的追赶生长。早产（41%）、小于胎龄（17%）或伴有相关畸形（55%）的患儿在1岁时发生营养不良和发育迟缓的风险更高（P<0.05）。EA类型和手术治疗均与生长发育不良无关。
EA患儿出生后第一年营养不良和发育迟缓很常见。这些结果受早期因素的显著影响，与EA类型或手术管理无关。识别EA高危患者群体（即早产、小于胎龄和/或伴有相关畸形的患儿）可能有助于指导早期营养支持策略。
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