title: Predictors of low weight and tube feedings in children with congenital diaphragmatic hernia at 1 year of age.
abstract: OBJECTIVE
  Congenital diaphragmatic hernia (CDH) survivors often have gastrointestinal disorders, and limited outcome data exist. This study reviewed risk factors for low weight and use of feeding tubes after CDH repair at 1 year of age. The hypothesis was that patients who required extracorporeal membrane oxygenation (ECMO) or with significant pulmonary arterial hypertension (PAH) would have lower weight percentiles and more often require tube feedings.
  
  
  METHODS
  A retrospective chart review of 89 infants with CDH diagnosed in the neonatal period was conducted. Statistical analysis was performed using χ test, Fisher exact test, and logistic regression.
  
  
  RESULTS
  Seventy-two patients (81%) survived to 1 year of age. Of these patients, 35% were <5th percentile for weight and 18% were receiving tube feedings. Both ECMO and PAH were associated with an increased risk for requiring tube feedings at 1 year of age, with respective odds ratios of 6.00 (P = 0.01) and 15.75 (P = 0.02); however, neither ECMO nor PAH was associated with low weight at 1 year of age. No statistical correlation was found between an abnormal pH probe and tube feedings at 1 year of age.
  
  
  CONCLUSIONS
  Patients with CDH are at increased risk for having a weight <5th percentile at 1 year of age. A history of ECMO and PAH are independently associated with an increased requirement for tube feedings at 1 year of age. Close nutritional monitoring and counseling should be considered in all of the patients with CDH, particularly those with a history of ECMO or PAH.
authors.affiliation: *Division of Pediatric Gastroenterology, Hepatology, and Nutrition †Division of Pediatric Surgery ‡Division of Neonatology §Mailman School of Public Health ||Division of Clinical Genetics ¶Division of Pediatric Cardiology, Columbia University, New York, NY.
authors.forename: Anne
authors.initials: A
authors.lastname: Pierog
authors.forename: Gudrun
authors.initials: G
authors.lastname: Aspelund
authors.forename: Christiana
authors.initials: C
authors.lastname: Farkouh-Karoleski
authors.forename: Mengfei
authors.initials: M
authors.lastname: Wu
authors.forename: Joshua
authors.initials: J
authors.lastname: Kriger
authors.forename: Julia
authors.initials: J
authors.lastname: Wynn
authors.forename: Usha
authors.initials: U
authors.lastname: Krishnan
authors.forename: Ali
authors.initials: A
authors.lastname: Mencin
mesh_terms: D004750:Enteral Nutrition; D015199:Extracorporeal Membrane Oxygenation; D005260:Female; D006130:Growth Disorders / Q000209:etiology*; D006548:Hernia, Diaphragmatic / Q000150:complications* / Q000628:therapy; D065630:Hernias, Diaphragmatic, Congenital / Q000150:complications* / Q000628:therapy; D006801:Humans; D007223:Infant; D016015:Logistic Models; D008297:Male; D016017:Odds Ratio; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D013851:Thinness / Q000453:epidemiology / Q000209:etiology*