Abstract
Objective Infants with a history of neonatal hypoxic-ischemic encephalopathy (HIE) are at risk
for oral motor dysfunction. Previous studies have associated the need for gastrostomy
tube at neonatal intensive care unit discharge with brainstem injury on magnetic resonance
imaging (MRI). However, the factors associated with time to full oral feeds in this
population have not been previously described. This study aimed to study factors associated
with time to full oral feeds in this population.
Study Design This is a single-center, retrospective study that examined these factors using Cox
regression.
Results A total of 150 infants who received therapeutic hypothermia from 2011 to 2017 were
included in this study. The single clinical factor significantly associated with time
to full oral feeds was the severity of background abnormality on electroencephalogram
in the first 24 hours of age (severe vs. mild 95% confidence interval [CI]: 0.34–0.74;
moderate vs. mild 95% CI: 0.19–0.45). Brainstem injury on MRI was the factor most
highly associated with need for gastrostomy tube placement (p = 0.028), though the overall incidence of need for gastrostomy tube feeds in this
population was low (5%).
Conclusion These findings may help clinicians counsel families on what to expect in neonates
with HIE and make decisions on the need for and timing to pursue gastrostomy tube
in this population.
Key Points
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The overall incidence of the need for assisted feeding at NICU discharge is low in
this population.
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MRI brainstem injury was most highly associated with need for gastrostomy tube placement.
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Worsening severity of background abnormality on EEG was associated with longer time
to oral feeds.
Keywords
neonate - hypoxia–ischemia - hypoxic–ischemic encephalopathy - oral feeding
