High Prevalence of Esophageal Acid Exposure in Very Low Birth Weight Infants Presenting or Not Bronchopulmonary Dysplasia: A Prospective Cross-Sectional Study
|Thaís Mendes-Lopes1, José Dirceu Ribeiro2 and Maria Aparecida Mezzacappa3*|
|1 Child and Adolescent Healthcare Program, University ofCampinas School of Medicine-UNICAMP, Campinas/São Paulo/Brazil|
|2 Department of Pediatrics, University of Campinas School of Medicine-UNICAMP, Campinas/São Paulo/Brazil|
|3 Division of Neonatology, Department of Pediatrics, University of Campinas School of Medicine-UNICAMP,Campinas/São Paulo/Brazil|
|Corresponding Author :||Maria Aparecida Mezzacappa
101 Alexander Fleming St. Cidade Universitária Zeferino Vaz
PO Box: 6081,13083-881, Campinas
São Paulo, Brazil
E-mail: [email protected], [email protected]
|Received December 14, 2013; Accepted February 14, 2014; Published February 16, 2014|
|Citation: Mendes-Lopes T, Ribeiro JD, Mezzacappa MA (2014) High Prevalence of Esophageal Acid Exposure in Very Low Birth Weight Infants Presenting or Not Bronchopulmonary Dysplasia: A Prospective Cross-Sectional Study. J NeonatalBiol 3:127. doi:10.4172/2167-0897.1000127|
|Copyright: © 2014 Mendes-Lopes T, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.|
Background: A high frequency of treatment for gastroesophageal reflux disease is observed in neonates with Bronchopulmonary Dysplasia (BPD). The association between these illnesses is controversial. Objective: To determine the prevalence of reflux index ≥ 10%, in very low birth weight infants, presenting or not BPD, using esophageal pH monitoring.
Methods: A prospective cross-sectional study was conducted. Thirty-five newborns presenting BPD and 15 newborns not presenting BPD underwent distal esophageal pH monitoring during their stay in a university hospital neonatal unit. The frequency of symptoms and gastroesophageal reflux treatment was studied in both groups.
Results: The prevalence of reflux index ≥ 10% did not differ between groups presenting (65.7%) and not presenting BPD (93.3%); p=0.075. Symptoms attributable to gastroesophageal reflux occurred in 91.4% of newborns presenting BPD and in 73.3% of the group not presenting BPD. Antireflux treatment was introduced to 80% of the subjects presenting BPD and to 20% of patients who were not presenting BPD; (p<0.001).
Conclusions:There is a high prevalence of increased esophageal mucosal exposure to acid in very low birth weight infants presenting or not BDP. The symptoms attributable to gastroesophageal reflux are frequent in both groups; however, in very low birth weight infants, not presenting BPD, a clinical progression complicated by gastroesophageal reflux is less frequent. Nevertheless, BPD is associated with a higher frequency of gastroesophageal reflux treatment, the indication of any therapeutic modality must be cautious, and the laboratory investigation associated with a clinical evaluation may contribute to a reduction in the number of unnecessary treatment.