title: Feeding immaturity in preterm neonates: risk factors for oropharyngeal aspiration and timing of maturation.
abstract: OBJECTIVE
  Oropharyngeal aspiration (OPA) is a common cause of morbidity in premature neonates. We sought to identify significant risk factors and determine the timing of feeding maturation in preterm infants with OPA.
  
  
  METHODS
  We performed a retrospective medical record review of 148 former preterm neonates referred for modified barium swallow study (MBSS) during a 3-year period. We looked at the MBSS results and potential clinical and demographic risk factors and performed bivariate and multivariable logistic regression analyses to evaluate predictors of failure. We evaluated the timing of resolution of OPA based on MBSS results.
  
  
  RESULTS
  Of the 148 infants comprising our study cohort, 47 (32%) passed their initial MBSS and 101 (68%) were found to aspirate thin liquids. Infants who aspirate had younger corrected gestational age (CGA) and postnatal age at the time of testing. Increasing CGA led to lower odds of failing. Infants passed a MBSS at a median CGA of 53 weeks and those who failed an initial MBSS eventually passed after a median of ∼3.4 months from the first study. Infants with bronchopulmonary dysplasia had lower odds of failing their MBSS (odds ratio 0.16), but those taking inhaled corticosteroids and diuretics had higher odds of failing, and infants who were multiples also had higher odds of failing.
  
  
  CONCLUSIONS
  We determined the median CGA for passing MBSS and identified risk factors for OPA in this population. This information can help guide providers when counseling families on timing of feeding maturity and anticipation of appropriate timing for follow-up MBSS testing.
authors: *Division of Neonatology, University of Maryland Hospital for Children, Baltimore, MD †Division of Respiratory Diseases, Boston Children's Hospital, Boston, MA.
authors: Natalie L
authors: NL
authors: Davis
authors: Ann
authors: A
authors: Liu
authors: Lawrence
authors: L
authors: Rhein
mesh_terms: D000305:Adrenal Cortex Hormones / Q000494:pharmacology; D001464:Barium; D001997:Bronchopulmonary Dysplasia; D003679:Deglutition; D004232:Diuretics / Q000494:pharmacology; D004435:Eating / Q000187:drug effects; D005260:Female; D005865:Gestational Age; D006801:Humans; D007223:Infant; D052577:Infant, Extremely Low Birth Weight; D007231:Infant, Newborn; D007234:Infant, Premature / Q000254:growth & development*; D007235:Infant, Premature, Diseases / Q000209:etiology*; D016015:Logistic Models; D008297:Male; D016017:Odds Ratio; D012119:Respiration; D053120:Respiratory Aspiration / Q000209:etiology*; D012189:Retrospective Studies; D012307:Risk Factors; D013391:Sucking Behavior
chemical_list: D000305:Adrenal Cortex Hormones; D004232:Diuretics; D001464:Barium