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Transpyloric feeding is associated with adverse in-hospital outcomes in infants with severe bronchopulmonary dysplasia

Journal of Perinatology volume 44, pages 307–313 (2024)Cite this article

Subjects

Abstract

Objective

To estimate the association of transpyloric feeding (TPF) with the composite outcome of tracheostomy or death for patients with severe bronchopulmonary dysplasia (sBPD).

Study design

Retrospective multi-center cohort study of preterm infants <32 weeks with sBPD receiving enteral feedings. We compared infants who received TPF at 36, 44, or 50 weeks post-menstrual age to those who did not receive TPF at any of those timepoints. Odds ratios were adjusted for gestational age, small for gestational age, male sex, and invasive ventilation and FiO2 at 36 weeks.

Results

Among 1039 patients, 129 (12%) received TPF. TPF was associated with an increased odds of tracheostomy or death (aOR 3.5, 95% CI 2.0–6.1) and prolonged length of stay or death (aOR 3.1, 95% CI 1.9–5.2).

Conclusions

Use of TPF in sBPD after 36 weeks was infrequent and associated with worse in-hospital outcomes, even after adjusting for respiratory severity at 36 weeks.

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Fig. 1: Study flow diagram.
Fig. 2: Outcome by exposure to transpyloric feeds.
Fig. 3: Adjusted odds ratios with exposure to transpyloric feeds.

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Data availability

A de-identified dataset is available upon request.

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Funding

This work was supported by the Gerber Foundation (JC Levin) and NIH/NHBLI K23 HL136851 (LP Hayden).

Author information

Authors and Affiliations

  1. Boston Children’s Hospital and Harvard Medical School, Boston, MA, USA

    Jonathan C. Levin, Lystra P. Hayden, Rachel L. Rosen & Kristen T. Leeman

  2. Nationwide Children’s Hospital and The Ohio State University College of Medicine, Columbus, OH, USA

    Matthew J. Kielt, Sara Conroy & Leif D. Nelin

  3. Children’s Mercy Hospital and University of Missouri-Kansas City School of Medicine, Kansas City, MO, USA

    William E. Truog

  4. Texas Children’s Hospital and Baylor College of Medicine, Houston, TX, USA

    Milenka Cuevas Guaman

  5. Children’s Hospital Colorado and University of Colorado School of Medicine, Aurora, CO, USA

    Steven H. Abman

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  1. Jonathan C. Levin
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Contributions

JCL, MJK, KTL conceptualized the manuscript. JCL and MJK conducted the analyses. JCL, MJK, LPH, SEC, and KTL interpreted the results of the analysis. JCL, MJK, LPH, LDN contributed data. WET, MCG, SHA, LDN, RLR, and KTL provided supervision, resources, and oversight. JCL wrote the initial draft of the manuscript; all authors reviewed the manuscript and approved its final version for submission.

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Correspondence to Jonathan C. Levin.

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Levin, J.C., Kielt, M.J., Hayden, L.P. et al. Transpyloric feeding is associated with adverse in-hospital outcomes in infants with severe bronchopulmonary dysplasia. J Perinatol 44, 307–313 (2024). https://doi.org/10.1038/s41372-024-01867-w

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