Medical intervention in parent-reported infant gastro-oesophageal reflux: A population-based study

作者：Sun Hua; Peters Rachel L; Allen Katrina J^*; Dharmage Shyamali C; Tang Mimi L K; Wake Melissa; Foskey Rebecca; Heine Ralf G

来源：Journal of Paediatrics and Child Health, 2015, 51(5): 515-523.

DOI：10.1111/jpc.12760

• cows milk allergy
• epidemiology
• food allergy
• health care utilisation
• reflux
• regurgitation

AimTo report the cumulative incidence, health-seeking behaviour and medical intervention of infants with gastro-oesophageal reflux (GOR) in the first year of life.
MethodsThe HealthNuts study is a longitudinal, population-based study. At 12 months of age, infants underwent skin prick testing to food allergens, including cows milk. Parents completed a questionnaire on GOR symptoms, food allergy and treatments. Factors associated with seeking health care for infants with GOR were modelled using logistic regression.
ResultsOf 4674 infants, parents reported GOR in 1054 (23%; 95% confidence interval (CI) 21.4-23.8). Parents consulted a medical practitioner in 662 (64%) cases. Symptoms commenced in the first month in 411 (48%) and resolved within 6 months in 703 (75%) infants. Factors associated with doctor consultation for GOR were prematurity (adjusted odds ratio (aOR) 1.94; 95% CI 1.43-2.63) and family history of atopy (aOR 1.64; 95% CI 1.1-2.43). Eight per cent of infants (371/4674; 95% CI 7.2-8.7) received anti-reflux medication and 6% (296/4674; 95% CI 5.7-7.1) changed formula. Parents were more likely to seek treatment if they perceived their infant to be unsettled (aOR 2.55; 95% CI 1.26-5.17) and if the duration of GOR was prolonged (aOR 3.36 for symptoms >6 months; 95% CI 1.83-6.17).
ConclusionsIn the first year of life, approximately 14% of the population seek medical advice for GOR symptoms. The use of anti-reflux medication in the general community remains high, despite the absence of evidence that it is appropriate or effective for uncomplicated GOR.

• 出版日期2015-5
• 单位复旦大学