High Frecuency of Gastroesophageal Reflux Disease in Symptomatic Preterm Infants

Abstract

Introduction: Gastroesophageal reflux (GER) occurs commonly in newborn infants and mostly among preterm infants. Gastroesophageal reflux disease (GERD) is clinically significant GER that causes morbidity, such as frequent vomiting, aspiration pneumonia, irritability, and can influence growth, length of hospital stay, and respiratory outcome. Esophageal 24-hours pH monitoring is the most widely employed diagnostic test for GER in preterm infants. Methods: We included 58 consecutive symptomatic neonates (≤1 month old) who underwent esophageal 24- hours pH monitoring from January 2014 to March 2016 in a tertiary refereal center. Each patient had previously fulfilled 3 basic clinical findings supporting GERD diagnosis, including frequent vomiting, failure to thrive and exacerbation of respiratory symptoms. The diagnosis of GERD was made by Boix-Ochoa Score ≥16.6. Frequencies were expressed as percentages. Statistical comparison between groups was performed using X2 and Student's T test. Results: A total of 20 studies were positive for GERD (34.48%). The mean age of the population without GERD was 38.33 weeks of gestation (WOG). Most of the neonates with GERD were male 70% (N=14). The mean age of the population with GERD was 33.92 ± 2.65 weeks of gestation WOG and the mean value of Boix-Ochoa Score was 67.77 ± 65. Most of the reflux events occur in the postprandial period 85% (N=17), and in supine position 70% (N=14). The Symptom Index was positive in 38.9% (N=7) and Symptom Association Probability (SAP) was positive in 55.6% (N=10). There was a significant association between female gender and a positive Symptom Index and between WOG and the presence of GERD p < 0.005. Conclusion: There is an association between prematurity and the diagnosis of GERD. The SAP could be more sensitive to GERD diagnosis in this population.