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Diagnostic utility of impedance-pH monitoring in infants of diabetic mothers with oral feeding difficulties

Journal of Perinatology volume 41, pages 1886–1892 (2021)Cite this article

Subjects

Abstract

Objective

To determine the diagnostic utility of impedance-pH monitoring in infants of diabetic mothers (IDM) with oral feeding difficulties.

Study design

Retrospective review of a consecutive sample of 50 IDM who had impedance-pH monitoring for objective gastroesophageal reflux disease (GERD) diagnosis. Acid reflux index (ARI) ≥ 7 was considered pathological (ARI+).

Results

Impedance-pH monitoring was performed at 42.1-week postmenstrual age. Twenty infants (40%) with ARI+ compared to 30 with ARI < 7 (ARI−). ARI+ had lower weight at study vs. ARI− (p < 0.05). ARI+ had significantly higher reflux parameters but had similar symptom burden and symptom-association scores vs. ARI−. All ARI+ received proton-pump inhibitors (PPI) vs. 7 (23.3%) in ARI− (p < 0.05), but oral feeding outcomes, gastrostomy rate, growth, and hospital length of stay were similar in both groups.

Conclusions

The diagnostic yield of impedance-pH monitoring in IDM is about 40%. However, GERD diagnosis or treatment with PPI did not modify short-term clinical outcomes.

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Acknowledgements

We thank Ms. Zakia Sultana, Research Assistant at the Innovative Infant Feeding Disorders Research Program, at Nationwide Children’s Hospital, Columbus, OH, USA for help with the data collection.

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Authors and Affiliations

  1. Division of Neonatology, Department of Pediatrics, Nemours Children’s Hospital, University of Central Florida College of Medicine, Orlando, FL, USA

    Sreekanth Viswanathan

  2. Innovative Infant Feeding Disorders Research Program, The Research Institute at Nationwide Children’s Hospital, Columbus, OH, USA

    Sreekanth Viswanathan, Sahithee Batchu, Erika Osborn & Sudarshan Jadcherla

  3. Division of Neonatology, Department of Pediatrics, Nationwide Children’s Hospital, The Ohio State University College of Medicine, Columbus, OH, USA

    Erika Osborn & Sudarshan Jadcherla

Authors
  1. Sreekanth Viswanathan
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  2. Sahithee Batchu
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  4. Sudarshan Jadcherla
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Corresponding author

Correspondence to Sreekanth Viswanathan.

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A. Guarantor of the article: SV—MD, MS. B. Any potential competing conflicts of interests: none.

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Viswanathan, S., Batchu, S., Osborn, E. et al. Diagnostic utility of impedance-pH monitoring in infants of diabetic mothers with oral feeding difficulties. J Perinatol 41, 1886–1892 (2021). https://doi.org/10.1038/s41372-020-00832-7

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  • DOI: https://doi.org/10.1038/s41372-020-00832-7

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