title: Eating difficulties in children born late and moderately preterm at 2 y of age: a prospective population-based cohort study.
abstract: BACKGROUND
  Very preterm (<32 wk of gestation) infants are at increased risk of eating difficulties compared with their term-born peers. Little is known about the impact of late and moderately preterm (LMPT; 32-36 wk of gestation) birth on eating difficulties in early childhood.
  
  
  OBJECTIVE
  The aims were to assess the prevalence of eating difficulties in infants born LMPT at 2 y corrected age and to explore the impact of neonatal and neurodevelopmental factors.
  
  
  METHODS
  A geographic population-based cohort of 1130 LMPT and 1255 term-born controls was recruited at birth. The parents of 651 (59%) LMPT and 771 (62%) term-born infants completed questionnaires at 2 y corrected age to assess neurodevelopmental outcomes. Parents also completed a validated questionnaire to assess eating behaviors in 4 domains: refusal/picky eating, oral motor problems, oral hypersensitivity, and eating behavior problems. Infants with scores >90th percentile were classified with eating difficulties in each domain. Neonatal data were collected at discharge, and sociodemographic information was collected via maternal interview. Poisson regression was used to assess between-group differences in eating difficulties and to explore associations with neonatal factors and neurodevelopmental outcomes at 2 y of age.
  
  
  RESULTS
  In unadjusted analyses, LMPT infants were at increased risk of refusal/picky eating (RR: 1.53; 95% CI: 1.03, 2.25) and oral motor problems (RR: 1.62; 95% CI: 1.06, 2.47). Prolonged nasogastric feeding >2 wk (RR: 1.87; 95% CI: 1.07, 3.25), behavior problems (RR: 2.95; 95% CI: 1.93, 4.52), and delayed social competence (RR: 2.28; 95% CI: 1.49, 3.48) were independently associated with eating difficulties in multivariable analyses. After adjustment for these factors, there was no excess of eating difficulties in LMPT infants.
  
  
  CONCLUSIONS
  Infants born LMPT are at increased risk of oral motor and picky eating problems at 2 y corrected age. However, these are mediated by other neurobehavioral sequelae in this population. This trial was registered on the UK Clinical Research Network Portfolio at http://public.ukcrn.org.uk/search/ as UKCRN Study ID 7441.
authors.affiliation: Department of Health Sciences, University of Leicester, Leicester, United Kingdom; and sjj19@le.ac.uk.
authors.forename: Samantha
authors.initials: S
authors.lastname: Johnson
authors.affiliation: Department of Health Sciences, University of Leicester, Leicester, United Kingdom; and.
authors.forename: Ruth
authors.initials: R
authors.lastname: Matthews
authors.affiliation: Department of Health Sciences, University of Leicester, Leicester, United Kingdom; and.
authors.forename: Elizabeth S
authors.initials: ES
authors.lastname: Draper
authors.affiliation: Department of Health Sciences, University of Leicester, Leicester, United Kingdom; and.
authors.forename: David J
authors.initials: DJ
authors.lastname: Field
authors.affiliation: Department of Health Sciences, University of Leicester, Leicester, United Kingdom; and.
authors.forename: Bradley N
authors.initials: BN
authors.lastname: Manktelow
authors.affiliation: Department of Academic Neonatology, Institute for Women's Health, University College London, London, United Kingdom.
authors.forename: Neil
authors.initials: N
authors.lastname: Marlow
authors.affiliation: Department of Health Sciences, University of Leicester, Leicester, United Kingdom; and.
authors.forename: Lucy K
authors.initials: LK
authors.lastname: Smith
authors.affiliation: Department of Health Sciences, University of Leicester, Leicester, United Kingdom; and.
authors.forename: Elaine M
authors.initials: EM
authors.lastname: Boyle
mesh_terms: D002657:Child Development; D002675:Child, Preschool; D015331:Cohort Studies; D004739:England / Q000453:epidemiology; D019959:Feeding and Eating Disorders of Childhood / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007231:Infant, Newborn; D007233:Infant, Postmature; D007234:Infant, Premature; D008297:Male; D055495:Neurogenesis; D009749:Nutrition Surveys; D010290:Parents; D016012:Poisson Distribution; D011247:Pregnancy; D011273:Pregnancy, Prolonged / Q000503:physiopathology*; D047928:Premature Birth / Q000503:physiopathology*; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors
keywords: eating behavior; gestational age; neurodevelopment; oral motor problems; preterm