Preterm infants born prior to 32 weeks gestation experience more symptoms of gastroesophageal reflux in the first 6 months of life than infants born at later gestational ages

Abstract

Background: Preterm infants hospitalized in the neonatal intensive care unit (NICU) often display symptoms of gastroesophageal reflux (GER). Little is known about symptoms of GER in this population after neonatal discharge. The purpose of this study was to describe symptoms of GER across the first 6 months of life in infants based on gestational age at birth and to explore factors associated with GER symptoms. Methods: This was a descriptive, cross-sectional study. Parents of 582 infants less than 6 months old participated in an online survey about their child’s symptoms of GER. Gestational age at birth, corrected age at time of study, infant sex, mode of birth, and family history of allergy were explored for their relationships to symptoms of GER. Results: Infants born at <32 weeks gestation had more symptoms of GER than infants born at later gestational ages. While full-term infants showed a decrease in symptoms across the first 6 months of life, infants born at 32–36 6/7 weeks showed no improvement, and infants born at <32 weeks gestation showed worsening symptoms over time. Infant sex and mode of birth were not associated with GER symptoms. Infants with a family history of allergy had more symptoms of GER than infants without a family history of allergy. Conclusions: Infants born prior to 32 weeks gestation experience more symptoms of GER than infants born at later gestation, with worsening of symptoms over the first 6 months of life. Preterm infants (<37 weeks gestation at birth) do not show the same improvement in symptoms over the first 6 months as full-term infants. Infants born 32 0/7–36 6/7 weeks, who may otherwise may be considered lower risk for morbidity than infants born before 32 weeks, did not experience the same improvement in symptoms over the first 6 months as full-term infants. Family history of allergy is related to increased symptoms of GER. Additional research is needed on the underlying mechanisms and evolution of GER symptoms in preterm infants.