Fatores de risco para doença de refluxo gastroesofagico em recem-nascidos com menos de 1500 gramas e displasia broncopulmonar / Risk factors for gastresophageal reflux in very low birthweight infants with bronchopulmonary dysplasia

AUTOR(ES)
DATA DE PUBLICAÇÃO

2006

RESUMO

Gastroesophageal reflux disease (GERD) is the most common illness in neonatal period, and is considered an associated factor for respiratory diseases. However, several aspects of GERD are controversy and not appropriately known in premature. Bronchopulmonary dysplasia (BPD) is the most common chronic lung disease in very low birth weight (VLBW) infants. Due to shortage of information?s about diagnosis of GERD in patients with BPD and considering the consequences about his morbidity, seems to us important to know the risk factors for the association, be able to collaborate with the improvement of quality of treatment. The objective of this study was to determine the risk factors for GERD in extremely low birth weight infants with BPD. A retrospective case-control study was realized, including 23 patients and 23 control subjects who were diagnosed by clinical manifestations and 24 hours esophageal pH monitoring presenting reflux index ? 10%. All newborn with BPD were studied from January 2001 to October 2005 at the Center for Women?s Integral Health Care. Cases and controls were compared for gestational age, birth weight, gender, antenatal steroid use, assisted ventilation time, oxygen therapy and time of feed tube use, xanthine, post conceptual age and weight on esophageal pH monitoring. For the statistic analysis were utilized, initially, the square? test and the Fisher?s exact test for the numerical variables, and Mann-Whitney?s test for category variables. Multiple logistic regression was made for to establish odds-ratio (OR) with confidence interval of 95% (CI). Were considered significant p<0.05. Both groups (with and without GERD) didn?t show significant differences on variables: demographics, postnatal evolution, prenatal and postnatal steroids use, caffeine utilization, mechanical ventilation and oxygen therapy. The variables feeding intolerance (OR 6.55; CI 1.05; 40.8) and time of gastric tube use (OR 1.67; CI 1.11; 2.51) showed be risk factors for GERD. The major post conceptual age on esophageal Ph monitoring (OR 0.02; CI <0.001; 0.38) showed be protector factor for GERD. The obtained data showed that a prolonged gastric tubes use and the feeding intolerance increase probability for GERD. While the major post conceptual age on esophageal pH monitoring decrease likelihood for GERD in premature neonates with BPD

ASSUNTO(S)

infant premature prematuros refluxo gastroesofagico gastroesophageal reflux recem-nascidos - peso baixo bronchopulmonary dysplasia displasia broncopulmonar very low birthweight

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