Nutritional outcomes in survivors of congenital diaphragmatic hernia (CDH)—Factors associated with growth at one year

BackgroundMalnutrition is prevalent among congenital diaphragmatic hernia (CDH) survivors. We aimed to describe the nutritional status and factors that impact growth over the 12-months following discharge from the pediatric intensive care unit (PICU) in this cohort.MethodsCDH survivors, who were discharged from the PICU from 2000 to 2010 with follow-up of at least 12 months, were included. Nutritional intake, anthropometric, and clinical variables were recorded. Multivariable linear regression was used to determine factors associated with weight-for-age Z-scores (WAZ) at 12 months.ResultsData from 110 infants, 67% male, 50% patch repair, were analyzed. Median (IQR) WAZ for the cohort was − 1.4 (− 2.4 to − 0.3) at PICU discharge and − 0.4 (− 1.3 to 0.2) at 12-months. The percentage of infants with significant malnutrition (WAZ < − 2) decreased from 26% to 8.5% (p < 0.001). Patch repair (p = 0.009), protein intake < 2.3 g/kg/day (p = 0.014), and birth weight (BW) < 2.5 kg (p < 0.001) were associated with lower WAZ at 12-months.ConclusionsCDH survivors had a significantly improved nutritional status in the 12-months after PICU discharge. Patch repair, lower BW, and inadequate protein intake were significant predictors of lower WAZ at 12-months. A minimum protein intake in the PICU of 2.3 g/kg/day was essential to ensure optimal growth in this cohort.