R. Ojala et al., Gastroesophageal endoscopic findings and gastrointestinal symptoms in preterm neonates with and without perinatal indomethacin exposure, J PED GASTR, 32(2), 2001, pp. 182-188
Citations number
32
Categorie Soggetti
Pediatrics,"Medical Research General Topics
Journal title
JOURNAL OF PEDIATRIC GASTROENTEROLOGY AND NUTRITION
Background: The aim of this study was to investigate whether perinatal indo
methacin treatment has effects on the development of esophageal and gastric
lesions in preterm infants and to evaluate other potential etiologic facto
rs behind these lesions.
Methods: Sixty-nine infants were born at less than 33 weeks' gestation. Fer
ry-five of these infants underwent treatment with perinatal indomethacin (s
tudy group) and 24 did not (control group). All underwent upper gastrointes
tinal tract endoscopy and biopsy during the neonatal period. The correlatio
n between gastrointestinal symptoms, abnormal endoscopic findings, and the
factors correlating with the development of esophageal and gastric mucosal
lesions was evaluated.
Results: Abnormal endoscopic findings were equally common in the study grou
p (77.8%) and in controls (83.3%). There was no dependence between gastroin
testinal symptoms and endoscopic findings because only 15 infants (21.7%) w
ere symptomatic before endoscopy. The interval between endoscopy and the la
st perinatal indomethacin dose correlated significantly,with abnormal esoph
ageal findings and gastric mucosal lesions. Shorter duration of enteral fee
ding before endoscopy correlated with greater risk of abnormal esophageal f
indings. Older gestational age and need of ventilator treatment at the time
of endoscopy remained the risk factors associated with abnormal gastric fi
ndings.
Conclusions: Esophageal and gastric lesions diagnosed by endoscopy correlat
e poorly with the,gastrointestinal symptoms of patients. Short duration of
enteral feeding seems to be correlated with an increased risk of esophageal
mucosal lesions, increasing gestational age and ventilator treatment with
gastric mucosal lesions, and perinatal indomethacin with esophageal and gas
tric mucosal lesions in preterm infants. Ventilator-treated preterm infants
not receiving enteral nutrition and patients with indomethacin exposure mi
ght benefit from ulcer prophylaxis.