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Oral Presentation - 33
Nutritional status at the age of 6 years of children operated at birth for oesophageal atresia
E Bitoumbou 1, A Bonnard 2, A Lapillonne 3, M Antoine 1, C Jacquier 4, N Caron 5, A Guinot 6, T Lamireau 7, S Irtan 8, L Bridoux-Henno 9, C Dumant 10, A Breton 11, J Lirussi Borgnon 12, I Talon 13, A Fabre 14, N Panait 14, A Ranke 15, F Laconi 16, V Fouquet 17, N Kalfa 18, D Djeddi 19, S Willot 20, C Dupont 21, A Turquet 22, C Crémillieux 23, E Darviot 24, C Borderon 25, O Jaby 26, M Pouzac 27, C Pelatan 28, A Comte 29, P De Vries 30, A Nicolas 31, V Triolo 32, C Tölg 33, S Geiss 34, L Cadart 1, F Gottrand 1, M Aumar 1
1 Lille University Hospital, Lille, France
2 University Hospital of APHP Robert Debré, Paris, France
3 University Hospital of APHP Necker-Enfants Malades, Paris, France
4 University Hospital of Grenoble Alpes, Grenoble, France
5 University Hospital of HCL Lyon, Lyon, France
6 University Hospital of Nantes, Nantes, France
7 University Hospital of Bordeaux, Bordeaux, France
8 University Hospital of APHP Armand Trousseau, Paris, France
9 University Hospital of Rennes, Rennes, France
10 University Hospital of Rouen, Rouen, France
11 University Hospital of Toulouse, Toulouse, France
12 University Hospital of Dijon, Dijon, France
13 University Hospital of Strasbourg, Strasbourg, France
14 University Hospital of Marseille, Marseille, France
15 University Hospital of Nancy, Nancy, France
16 University Hospital of Reims, Reims, France
17 University Hospital of APHP Kremlin Bicêtre, Paris, France
18 University Hospital of Montpellier, Montpellier, France
19 University Hospital of Amiens, Amiens, France
20 University Hospital of Tours, Tours, France
21 University Hospital of Caen, Caen, France
22 University Hospital of La Réunion, Saint Denis de la Réunion, France
23 Saint Etienne University Hospital Centre
24 University Hospital of Angers, Angers, France
25 University Hospital of Clermont-Ferrand, Clermont-Ferrand, France
26 Hospital of Créteil, Créteil, France
27 University Hospital of Orléans, Orléans, France
28 Hospital of Le Mans, Le Mans, France
29 University Hospital of Besançon, Besançon, France
30 University Hospital of Brest, Brest, France
31 University Hospital of Limoges, Limoges, France
32 University Hospital of Nice, Nice, France
33 University Hospital of Fort De France, Martinique, France
34 Hospital of Colmar, Colmar, France
Objectives and study
Due to motility abnormalities and digestive complications, oesophageal atresia (OA) affects food intake and possibly nutritional status. Undernutrition has been shown to affect about 15% of the patients at the age of one year, but the long-term nutritional outcome of these patients remains poorly studied. Our objective was to assess the prevalence and predictive factors of undernutrition and stunting of patients at 6 years old.
Methods
We conducted a prospective, multicentric, nested cohort study. Data of every consecutive patient born in France with OA between 2010 and 2012 were recorded and merged with data collected at birth and 1 year of age in our national registry of OA. Undernutrition and stunting were defined by z-scores of BMI and height-for-age ratio less than -2 standard deviations, respectively. Uni- and multivariate analyses were performed thanks to the imputation of missing data.
Results
We included 449 of the 468 eligible patients (92%). Prevalence of undernutrition and stunting at 6 years was respectively 9.0% and 11.1%. Undernutrition at one year of age was the only independent factor predictive for undernutrition at the age of 6 (OR 4.37 (IC95% 1.77 to 10.77), p=0.002), while being small for gestational age, a congenital heart malformation and preexisting stunting at one year were independent factors predictive for stunting at 6 years (OR 2.32 (IC95% 1.01 to 5.33),p = 0.048, OR 1.99 (IC95% 1.00 to 3.93), p = 0.049; and OR 5.51 (IC95% 2.31 to 13.18), p=0.0002, respectively).
Conclusion
Our study highlights that undernutrition and stunting remain frequent in the middle-term follow-up in OA and originate mainly during the first year of life.