Severity of respiratory disease is correlated with time of first oral
feeding and need for a gastrostomy tube at discharge in premature
infants born at <30 weeks of gestation
Abstract
Background: Premature infants who cannot achieve full oral feeds may
need a gastrostomy tube (GT) to be discharged from the neonatal
intensive care unit (NICU). We previously developed a model to predict
which infants born <30 weeks (w) gestational age (GA) will
require a GT before discharge. Here we report the detailed respiratory
variable data to describe the general respiratory course for infants in
the NICU <30w GA at birth and the association between
different levels of respiratory support with postmenstrual age (PMA) at
the time of first oral feeding attempt (PMAff), including later need for
GT for discharge. Methods: Retrospective chart review of 391 NICU
admissions comprising test (2015-2016) and validation (2017-2018)
cohorts. Data, including respiratory support, were collected on 204
infants, 41 GT and 163 non-GT, in the test cohort, and 187 infants, 37
GT and 150 non-GT, in the validation cohort. Results: Respiratory data
were significantly different between GT and non-GT infants. Infants who
required GT for discharge were on significantly higher respiratory
support at 30 days of age, 32w PMA, and 36w PMA. Respiratory parameters
were highly correlated with PMAff. Conclusion: Respiratory status
predicts PMAff, which was the variable in our previously described model
that was most predictive of failure to achieve full oral feeing. These
data provide a catalyst to develop strategies for improving oral feeding
outcome for infants requiring prolonged respiratory support in the NICU.