Oesophageal atresia: The growth gap

Table 1 Factors associated with poor growth in children with oesophageal atresia

Ref.	Type of study	Population, setting	Growth measures	Significant findings
Andrassy et al[26], 1983	Cross-sectional	53 patients, age range 11 mo–31 yr	HFA, WFA, Triceps skin fold, Mid arm circumference SD scores	HFA SD score lower in children < 13 yr of age compared to > 13 yra
Puntis et al[28], 1990	Cross-sectional	124 patients, age range 0.5-23 yr	HFA and WFH SD scores	Oesophagostomy group had significantly lower mean WFHa and HFAb SD score than primary anastomosis group
Legrand et al[19], 2012	Retrospective and cross-sectional	57 patients, age range 9.5-18.5 yr	BMI, WFA, HFA and WFH z scores	Lower WFH z score in children with history of GORD compared to those without a history of GORDa
Spoel et al[35], 2012	Prospective follow up	37 children, age range 6 mo–2 yr	HFA and WFH SD scores	Thoracoscopy group had HFA SD significantly lower than thoracotomy groupb
				Thoracotomy group had WFH SD significantly lower than thoracoscopy groupb
Menzies et al[17], 2017	Retrospective	75 children, age range 0-16.8 yr	WFA, HFA and weight-for-length/BMI z score	Infants (< 1 yr), those who had undergone fundoplication, were at risk of aspiration and had surgery in the first year of life in addition to OA repair had lower mean BMI z scoresa
Vergouwe et al[18], 2017	Prospective follow-up	126 children, age range 0-12 yr	HFA, WFH and distance to target height SD scores	Results of multivariable linear mixed models showed: HFA SD scores negatively associated with low birthweightb and fundoplicationb
				WFH SD scores negatively associated with low birthweighta and fundoplicationb and positively associated with total number of surgeriesb and history of pulmonary infectionsa
				Distance to target height SD scores negatively associated with low birthweightb and fundoplicationb
Masuya et al[36], 2018	Retrospective	73 children, age range 6 yr 7 mo–24 yr)	HFA, WFA and BMI SD scores	HFA, WFA and BMI-for-age SD scores not associated with associated anomalies and late complications
Mawlana et al[37], 2018	Retrospective	57 patients, age range 9.5-18.5 yr	Weight, height, head circumference velocity percentile	45% of children with VACTERL had weight velocity < 10th centile compared to 13% of children without VACTERLb
Svoboda et al[15], 2018	Cross-sectional	928 patients, age range 1 mo-60 yr	WFA and HFA SD scores	Significantly lower mean score for HFA SD in children < 5 yr than > 5 yr (P value not reported)

^aP < 0.05.

^bP < 0.01. OA: Oesophageal atresia; HFA: Height-for-age; SD: Standard deviation; WFA: Weight-for-age; BMI: Body mass index; WFH: Weight-for-height; GORD: Gastro-oesophageal reflux disease; VACTERL: Vertebral anomalies, anal atresia, cardiac anomalies, tracheoesophageal fistula, renal anomalies and limb defects.

Table 2 Feeding difficulties in children with oesophageal atresia

Feeding difficulty	Ref.
Challenging mealtime behaviour	[17]
Delayed introduction of solids	[28]
Selective eating	[15,17]
Food refusal	[28,30,38,61]
Slow eating/lengthy mealtimes	[17,28,38,61,62]
Regurgitation of food	[58]
Food impaction	[27,30,54,62,63]
Coughing/choking during meals	[28,30,34,54,61]
Vomiting during meals	[28,57,61]
Texture avoidance	[17,57]