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Aspiration in the First Year of Life and Later Tube Feeding: A Retrospective Cohort from a Low-Income Country

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Abstract

The objective of this study is to investigate in infants submitted to videofluoroscopic swallowing study (VFSS) during the first year of life, the association between aspiration and later tube feeding, and to identify potential risk factors related to feeding route outcome. Retrospective cohort study with data from electronic health records was performed. Data were collected from infants < 12 months of age who underwent VFSS during inpatient hospital stay in the period between 2013 and 2018. Patient charts after 24 months of age were reviewed to ascertain the outcome and study factors, including VFSS findings, neonatal data, clinical comorbidities, nutritional status, ICU admissions, and hospital readmissions. Relative risk (RR) for tube feeding was calculated, and a Poisson regression with robust variance was used to identify potential risk factors. VFSS data from 164 patients < 1 year old were retrieved, of whom 112 (68%) contributed with data about feeding route after 2 years of age. Most infants were preterm < 37 weeks (66%), with a median age of 9.28 weeks at the time of the exam. Aspiration occurred in 33% of the patients, with no statistically significant difference between full-term or premature infants (p = 0.173). The relative risk of tube feeding after the age of 2 among infants who aspirated in VFSS was 0.74 (CI 0.25–2.16, p = 0.573). Poisson regression analysis showed that number of hospital readmissions (RR 1.04, 95%CI 1.01–1.07, p = 0.005) and gestational age < 34 weeks (RR 0.26, 95%CI 0.07–0.089, p = 0.032) were associated with later tube feeding. Early VFSS findings have low predictive value regarding later feeding route. Aspiration events should be considered as complementary information for clinical decision.

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Acknowledgements

We would like to thank the Universidade Federal do Rio Grande de Sul (UFRGS) and CAPES Foundation (Brazil) for granting a scholarship for the present study.

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Authors and Affiliations

  1. Graduate Program in Child and Adolescent, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil

    Priscilla Poliseni Miranda & Renata Rocha Kieling

  2. Speech and Language Pathology Service, Hospital de Clínicas de Porto Alegre, Ramiro Barcelos Street, 2350 – Room 1045, Porto Alegre, Rio Grande do Sul, 90035-903, Brazil

    Deborah Salle Levy

  3. Department of Health and Human Communication, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil

    Deborah Salle Levy

  4. Department of Pediatrics, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil

    Renata Rocha Kieling

Authors
  1. Priscilla Poliseni Miranda
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  2. Deborah Salle Levy
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  3. Renata Rocha Kieling
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Correspondence to Renata Rocha Kieling.

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The study was approved by the Institutional Review Board of the Hospital de Clínicas de Porto Alegre. A confidentiality term was signed by all researchers.

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Miranda, P.P., Levy, D.S. & Kieling, R.R. Aspiration in the First Year of Life and Later Tube Feeding: A Retrospective Cohort from a Low-Income Country. Dysphagia 38, 192–199 (2023). https://doi.org/10.1007/s00455-022-10450-4

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  • DOI: https://doi.org/10.1007/s00455-022-10450-4

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