Brain-gut axis disorders in preterm infants of a Kangaroo Program

Abstract

Introduction: Disorders of Gut Brain Interaction (DGBIs) in <4 years old occur in 22.0% of the cases, the main ones being: functional constipation (FC) (9.0%), regurgitation (8.0%) and infantile colic (3.0%). We do not know the prevalence in preterm newborns (PretNB) belonging to a Kangaroo Program (Kangaroo).

Objetive: To determine the prevalence of DGBIs in <36 months old of a Kangaroo at the Hospital Universitario del Valle (HUV) in Cali, Colombia, through the Questionnaire for Pediatric Gastrointestinal Symptoms Rome IV (QPGS-IV) and its possible associations.

Methods: Observational cross-sectional descriptive study carried out in PretNB caregivers using the QPGS-IV to identify the presence of DGBIs. Sociodemographic, clinical, family and nutritional variables were included. The statistical analysis included measures of central tendency, univariate and bivariate analysis, with the calculation of the ORs with their respective CI 95%, with a p<0.05 being significant.

Results: 281 patients <36 months old were analyzed (7.8+/-7.8 months old, 78.3% <12 months old, 50.9% female, 37.4% mixed race, 42.0% PretNB super-extreme). 22.8% presented some DGBI, their order of frequency being: 10.3% FC, 7.1% regurgitation, 2.1% infantile colic and dyschezia, respectively, 0.7% rumination and 0.4% diarrhea; with coexistence of DGBI in 3.6%, the most frequent being FC + regurgitation (2.1%). There was a greater chance of presenting some DGBI in those 25-36 months of age (OR=5.28 CI 95%=0.58-64.12 p=0.0452) and in the malnourished according to BMI (OR=2.26 CI 95%=0.94-5.62 p=0.0044). For FC, there was a greater chance in those who received complementary feeding (OR=2.84 CI 95%=1.19-7.11 p=0.0087) and had comorbidities (OR=2.73 CI 95%=1.08-6.59 p=0.0126), and as protective factors were breastfeeding (OR=0.37 CI 95%=0.15-0.90 p=0.0124) and clinical follow-up (OR=0.3 CI 95%=0.10-0.77 p=0.0058)

Conclusions: About ¼ part of these <36 months old PretNB, belonging to the HUV Kangaroo, presented some DGBI, the most frequent being FC, which was associated with children between 2-3 years old, to receive complementary and present comorbidities, with breastfeeding and clinical follow-up as protective factors.