682 - Time to Dysphagia Resolution in Preterm Infants

Publication Number: 4667.682

Katlyn McGrattan, University of Minnesota, Eden Prairie, MN, United States; Irena K. Wilson, University of Minnesota - Twin Cities, Minneapolis, MN, United States; Gregory P. Jansen, University of Minnesota, Minneapolis, MN, United States; Alicia Hofelich Mohr, University of Minnesota, Minneaplis, MN, United States

Background: It is well established that while nearly all premature infants will suffer from feeding deficits at some point in their hospital stay, these deficits typically resolve as the infant approaches term postmenstrual age. However, for 20% of infants these deficits will persist, with aspiration attributed as a common source. Little is known about the anticipated time it will take for aspiration to resolve in these cases, and enable infants to achieve functional feeding milestones on thin liquids. The aim of this investigation was to elucidate the time to recovery of dysphagia among preterm infants with penetration or aspiration identified during their neonatal hospital stay.

Objective: The objective of this investigation was to elucidate the time to recovery of dysphagia among preterm infants with penetration or aspiration identified during their neonatal hospital stay.

Design/Methods: A retrospective review of preterm infants who underwent a videofluoroscopic swallow study (VFSS) as part of their neonatal hospital stay between 2019-2023 was conducted. Infants were included if they exhibited penetration or aspiration on their initial exam, and had at least one follow-up VFSS to evaluate for improvement. Medical records were reviewed for background information as well as all videofluoroscopic and clinical assessment results, with survival analyses conducted to calculate the time to resolution of thin liquid penetration, thin liquid aspiration, and clinical tolerance of thin liquids. Survival analyses were conducted to calculate time to resolution, with results reported in proportions and means ± standard deviation.

Results: 70 infants (51% female) were included in the investigation. Gestational ages included infants born < 28 weeks (43%), 28-32 weeks (24%), and >32 weeks (33%), with average postmenstrual age (PMA) of 44 ± 6 weeks at the time of their initial VFSS. Infants had between 1-4 follow-up exams that were conducted an average of 18 ± 20 weeks apart. Examination of the timing to resolution of aspiration revealed the probability of aspiration resolution did not achieve 50% until 5 months PMA, and 75% until 15 months PMA. Interesting, the proportion of infants who exhibited resolution of penetration was so low (20%) that survival analyses could not be performed.

Conclusion(s): The majority of preterm infants who exhibit aspiration during routine inpatient clinical workup for prolonged feeding deficits will not experience resolution within the first year of life. Further investigation into the clinical significance of penetration is warranted.