Abstract
Objective
To determine the diagnostic utility of impedance-pH monitoring in infants of diabetic mothers (IDM) with oral feeding difficulties.
Study design
Retrospective review of a consecutive sample of 50 IDM who had impedance-pH monitoring for objective gastroesophageal reflux disease (GERD) diagnosis. Acid reflux index (ARI) ≥ 7 was considered pathological (ARI+).
Results
Impedance-pH monitoring was performed at 42.1-week postmenstrual age. Twenty infants (40%) with ARI+ compared to 30 with ARI < 7 (ARI−). ARI+ had lower weight at study vs. ARI− (p < 0.05). ARI+ had significantly higher reflux parameters but had similar symptom burden and symptom-association scores vs. ARI−. All ARI+ received proton-pump inhibitors (PPI) vs. 7 (23.3%) in ARI− (p < 0.05), but oral feeding outcomes, gastrostomy rate, growth, and hospital length of stay were similar in both groups.
Conclusions
The diagnostic yield of impedance-pH monitoring in IDM is about 40%. However, GERD diagnosis or treatment with PPI did not modify short-term clinical outcomes.
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Acknowledgements
We thank Ms. Zakia Sultana, Research Assistant at the Innovative Infant Feeding Disorders Research Program, at Nationwide Children’s Hospital, Columbus, OH, USA for help with the data collection.
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Viswanathan, S., Batchu, S., Osborn, E. et al. Diagnostic utility of impedance-pH monitoring in infants of diabetic mothers with oral feeding difficulties. J Perinatol 41, 1886–1892 (2021). https://doi.org/10.1038/s41372-020-00832-7
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DOI: https://doi.org/10.1038/s41372-020-00832-7
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