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Risk factors for and developmental relation of delayed oral nutrition in infants with congenital diaphragmatic hernia

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Abstract

Purpose

To identify risk factors for delayed oral nutrition in infants with a congenital diaphragmatic hernia (CDH) and its impact on developmental delay at 18 months of age.

Methods

This retrospective single-center cohort study compared the clinical parameters in patients with isolated CDH born and treated at our hospital between 2006 and 2020. We evaluated clinical features significantly related to delayed oral nutrition (defined as taking ≥ 30 days from weaning from mechanical ventilation to weaning from tube feeding).

Results

Twenty-six of the 80 cases had delayed oral nutrition. Univariate analyses showed significant differences. Multivariate analyses were performed on the three items of preterm delivery, defect size (over 50% to nearly entire defect), and ventilation for ≥ 9 days. We identified the latter two items as independent risk factors. The adjusted odds ratios were 4.65 (95% confidence interval, 1.27–7.03) and 6.02 (1.65–21.90), respectively. Delayed oral nutrition was related to a significantly higher probability of developmental delay at 18 months (crude odds ratio 4.16, 1.19–14.5).

Conclusion

In patients with CDH, a large defect and ventilatory management over 9 days are independent risk factors for delayed oral nutrition, which is a potent predictor of developmental delay that requires active developmental care.

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Data availability

Due to the nature of this research, participants of this study did not agree for their data to be shared publicly, so supporting data is not available.

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Acknowledgements

We would like to thank Editage (www.editage.com) for English language editing.

Funding

The authors have no relevant financial or non-financial interests to disclose.

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Authors and Affiliations

  1. Department of Pediatric Surgery, Osaka Women’s and Children’s Hospital, 840 Murodo, Izumi, Osaka, 594-1101, Japan

    Taku Yamamichi, Takaaki Sakai, Mina Yoshida, Keita Takayama, Naoko Uga, Satoshi Umeda & Noriaki Usui

  2. Division of Environmental Medicine and Population Sciences, Department of Social and Environmental Medicine, Graduate School of Medicine, Osaka University, Suita City, Osaka, Japan

    Yousuke Imanishi

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  1. Taku Yamamichi
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Contributions

All authors contributed to the study conception and design. Data collection and analysis were performed by all authors. The first draft of the manuscript was written by TY. The draft was reviewed and edited by Noriaki Usui, and all authors commented on the second version of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Taku Yamamichi.

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Yamamichi, T., Imanishi, Y., Sakai, T. et al. Risk factors for and developmental relation of delayed oral nutrition in infants with congenital diaphragmatic hernia. Pediatr Surg Int 40, 2 (2024). https://doi.org/10.1007/s00383-023-05595-8

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