Sonographic measurements of the abdominal esophageal length in premature neonates with and without gastro-esophageal reflux disease

Introduction: Recently, association between the length of abdominal esophagus and increased risk for gastro-esophageal reflux disease (GERD) has been hypothesized. The aim of the present study was to determine this relation. Methods: In a cross-sectional study, 75 consecutive premature neonates aged less than 30 days with birth weight less than 2000 gr hospitalized in Neonates’ ward of the Mahdieh hospital in Tehran were included into the study. The certain diagnosis of GERD was based on clinical manifestations. The presence of GERD and also measurement of the abdominal esophageal length was assessed by portable sonography using SIUI sonography device. Results: Clinically, reflux was diagnosed in 15 neonates (20.0%). It was also diagnosed in 20 cases (26.7%) by sonography assessment yielding a sensitivity of 86.7%, a specificity of 88.3%, a positive predictive value of 65.0%, a negative predictive value of 96.4%, and an accuracy of 88% for this diagnostic device. The mean length of abdominal esophagus was estimated 15.2 ± 4.1 mm. There was a strong positive association of the length of abdominal esophagus with neonatal birth weight (r = 0.553, P < 0.001)  and also with gestational age (r = 0.491, P = 0.001). In a multivariate linear regression model, shorter abdominal esophagus was shown to be related to the presence of reflux. Conclusion: Shorter abdominal esophagus in premature neonates is associated with increased risk for GERD that is more highlighted in those neonates with lower birth weight and lower gestational age. Sonography has a high value for assessment of abdominal esophageal length and reflux diagnosis in premature neonates. 

Sonographic measurements of the abdominal esophageal length in premature neonates with and without gastro-esophageal reflux disease Keywords:

Gastro-esophageal reflux disease , Abdominal esophageal length , PREMATURE NEONATES