Feeding and Growth Outcomes in Infants with Type C Esophageal Atresia Who Undergo Early Primary Repair

Abstract

To describe growth and feeding outcomes in patients with type C esophageal atresia who underwent early primary repair and to identify predictors for poor growth. This single-center, retrospective, cohort study included all patients with type C esophageal atresia who underwent early primary repair from 2013 to 2019. Weight-for-age z score (WAZ) was calculated at birth, and every 6months until 3years postoperatively. Longitudinal median regression was used to evaluate WAZ over time. A multivariable logistic regression model explored predictors of growth outcomes. Of 46 infants who met the inclusion criteria, 72% were term. The median age at repair was 1.5days of life (IQR, 1-2days of life) and the hospital length of stay was 20days (IQR-14, 30days). Two patients had esophageal leak (4.3%). The median WAZ at birth was below average (-0.72; IQR, -1.37 to -0.40), but improved to reach average by 3years (-0.025; IQR, -0.85 to 0.97, P<.001). At discharge, 72% of patients were receiving full oral nutrition, which improved to 95% by 3years. The only independent predictor of poor growth at 1year (WAZ < -1 [33%]) was WAZ at discharge (P=.02). Infants with esophageal atresia who undergo early primary repair are capable of achieving standard growth curves by 3years of age. However, poor discharge WAZ score was predictive of poor WAZ score at 1year. Efforts to identify at-risk patients and institute targeted inpatient and outpatient nutrition interventions are needed to improve their growth trajectory.