title: Initial treatment and early weight gain of children with Robin Sequence in Germany: a prospective epidemiological study.
abstract: BACKGROUND
  To investigate birth prevalence of Robin Sequence (RS), distribution of implemented treatments and factors influencing weight gain during initial hospitalisation.
  
  
  METHODS
  Prospective population-based survey (August 2011-July 2013) on new hospital admissions of infants with RS in Germany. RS was defined as retrognathia/micrognathia and at least one of the following: upper airway obstruction, snoring or hypoxaemia; glossoptosis; feeding difficulties; failure to thrive; cleft palate or RS-associated syndrome. Birth prevalence was calculated using data from the National Bureau of Statistics and in-hospital weight gain evaluated by calculating differences in SD scores (SDS) for weight. Comparisons between cohorts were performed using the Wilcoxon/Kruskal-Wallis test or Fisher's exact test.
  
  
  RESULTS
  151 patients with RS could be verified resulting in a birth prevalence of 11.3 per 100,000 live births. Orthodontic therapy (feeding plate or pre-epiglottic baton plate, PEBP) was applied most frequently (107 infants), followed by prone positioning (97 infants). Tracheotomy was rarely performed (n=7). For 115 infants, implementation of more than one intervention was reported. Infants with serious respiratory difficulties during initial hospitalisation (n=58) showed a more pronounced decrease in SDS for weight (median (IQR) -0.81 (-1.32 to -0.26) vs -0.48 (-0.86 to 0.02); p=0.008) whereas treatment with PEBP was associated with better weight gain (SDS-difference for weight -0.37 (-1.06 to 0.02) vs -0.74 (-1.09 to -0.35); p=0.022).
  
  
  CONCLUSIONS
  Non-surgical management is preferred for infants with RS in Germany. The extent of upper airway obstruction seemed to influence in-hospital weight gain, while use of the PEBP was associated with improved early weight gain.
authors.affiliation: Department of Neonatology, University Hospital, Tuebingen, Germany.
authors.forename: Christoph
authors.initials: C
authors.lastname: Maas
authors.affiliation: Department of Neonatology, University Hospital, Tuebingen, Germany.
authors.forename: Christian F
authors.initials: CF
authors.lastname: Poets
mesh_terms: D000402:Airway Obstruction / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy; D001724:Birth Weight; D005260:Female; D005858:Germany / Q000453:epidemiology; D006760:Hospitalization; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007902:Length of Stay; D008297:Male; D009971:Orthodontics, Corrective / Q000379:methods; D010158:Palatal Obturators; D010855:Pierre Robin Syndrome / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy*; D015995:Prevalence; D011446:Prospective Studies; D012131:Respiratory Insufficiency / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy; D015430:Weight Gain / Q000502:physiology*
keywords: Congenital Abnorm; Epidemiology