Published online December 31, 2007
PEDIATRICS Vol. 121 No. 1 January 2008, pp. 22-27 (doi:10.1542/peds.2007-0381)

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ARTICLE

Use of Medications for Gastroesophageal Reflux at Discharge Among Extremely Low Birth Weight Infants

William F. Malcolm, MD^a, Marie Gantz, PhD^b, Richard J. Martin, MD^c, Ricki F. Goldstein, MD^a, Ronald N. Goldberg, MD^a, Charles M. Cotten, MD, MHS^a for the National Institute of Child Health and Human Development Neonatal Research Network

^a Department of Pediatrics, Duke University, Durham, North Carolina
^b Research Triangle Institute International, Research Triangle Park, North Carolina
^c Department of Pediatrics, Case Western Reserve University, Cleveland, Ohio

OBJECTIVES. Our goals were (1) to determine the use of medications to treat gastroesophageal reflux in extremely low birth weight infants (birth weight of <1000 g) at discharge; (2) to identify risk factors associated with the use of medications to treat gastroesophageal reflux at discharge; and (3) to assess the contribution of gastroesophageal reflux medication use at discharge to growth and development at corrected ages of 18 to 22 months.

METHODS. This retrospective cohort analysis included extremely low birth weight infants enrolled at National Institute of Child Health and Human Development Neonatal Research Network Centers between 2002 and 2003 who survived to follow-up evaluations at corrected ages of 18 to 22 months. Analyses were used to identify factors associated with discharge with antireflux medications and poor growth or neurodevelopmental impairment after discharge.

RESULTS. A total of 1598 infants were included in the analyses; 24.8% were discharged from the hospital with medications to treat gastroesophageal reflux. A total of 19.3% of the 1287 infants discharged at postmenstrual age of 42 weeks were discharged with antireflux medications. For those infants, center, lower gestational age, and race had significant effects on the use of antireflux medications at discharge. A total of 47.6% of the 311 infants discharged at postmenstrual age of >42 weeks were discharged with antireflux medications. For those infants, no tested variables were associated with treatment with antireflux medications at discharge. Use of antireflux medications at discharge was not associated with either poor growth or neurodevelopmental impairment at corrected ages of 18 to 22 months.

CONCLUSIONS. Use of antireflux medications at the time of discharge seems to be common for extremely low birth weight infants, especially those discharged at postmenstrual age of >42 weeks, but does not seem to have effects on growth or development at the time of follow-up evaluations.

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Key Words: gastroesophageal reflux • infant • premature • low birth weight • antacid • growth • development

Abbreviations: GER—gastroesophageal reflux • PMA—postmenstrual age • ELBW—extremely low birth weight

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Accepted Jul 6, 2007.

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