Department of Pediatric Surgery, Universitätsmedizin, Johannes Gutenberg-University, 55131, Mainz, Germany.
Kinder und Erwachsene mit kranker Speiseröhre, KEKS e.V., Stuttgart, Germany.
BMC Pediatr. 2023 Jan 18;23(1):27. doi: 10.1186/s12887-023-03842-4.
Esophageal atresia (EA) is a rare malformation with a wide range of co-morbidity and associated malformations impairing weight gain and growth. The aim of this study was to calculate specific percentiles for body weight and height for children born with esophageal atresia according to sex from birth to the age of 6 years, accounting for prematurity and presence of congenital heart disease (CHD).
Data was extracted from an anonymized voluntary national registry for patients born with esophageal atresia between 2001 and 2021, from birth until the age of six years. Missing values were imputed using a multiple imputation approach. In premature infants, chronological age was corrected for gestational week until the age of one year. The impact of sex and additional congenital heart disease on weight gain and growth was analysed using quartile regression models.
In total, 1812 examinations of 485 patients were considered and 1232 examinations of 301 patients were finally included. Most data was available for children at birth and during the first year of life. Body weight was imputed for 3.3% and height for 12.5% of examinations. The mean body weight-for-age and length-for-age at birth according to gestational age was lower in EA patients and median body weight developed along the tenth percentile compared to the general population. Median height-for-age was at the 50th percentile during the first months of life, before crossing to lower percentiles before the age of one year. CHD had an additional negative impact on growth and weight gain, especially during the first year of life.
Children with EA had a reduced bodyweight and -height compared to the general population. Therefore, specific percentile curves are helpful to evaluate growth and development. Especially during the first year of life, particular attention is necessary and complications leading to a reduced calorie intake should be treated without delay to promote timely development and growth. Cardiac co-morbidities may further compromise weight gain in these patients, implying that such patients should be under even closer surveillance.
食管闭锁（EA）是一种罕见的畸形，其并发症和相关畸形的范围广泛，会影响体重增加和生长。本研究的目的是计算出生至 6 岁的 EA 患儿的体重和身高的特定百分位数，考虑到早产和先天性心脏病（CHD）的存在。
从 2001 年至 2021 年，从出生到 6 岁，从一个匿名的全国性自愿登记处提取数据。使用多重插补方法填补缺失值。在早产儿中，直到一岁时，将年龄校正为胎龄周数。使用四分位回归模型分析性别和其他先天性心脏病对体重增加和生长的影响。
总共考虑了 485 名患者的 1812 次检查，最终纳入了 301 名患者的 1232 次检查。出生和生命的第一年有最多的数据。体重的检查有 3.3%需要插补，身高的检查有 12.5%需要插补。根据胎龄，EA 患者的出生时体重和身长低于平均值，中位数体重的发育与人群的第 10 百分位相比。在生命的最初几个月，身高中位数处于第 50 百分位，然后在一岁前交叉到较低的百分位。CHD 对生长和体重增加有额外的负面影响，尤其是在生命的第一年。
与一般人群相比，EA 患儿的体重和身高较低。因此，特定的百分位曲线有助于评估生长发育。特别是在生命的第一年，需要特别注意，并应立即治疗导致热量摄入减少的并发症，以促进及时发育和生长。心脏合并症可能会进一步影响这些患者的体重增加，这意味着这些患者应受到更密切的监测。
