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22-01-2012 | Gastroenterology | Article

Manipulative therapy reduces gastrointestinal symptoms, length of stay in premature infants


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MedWire News: Osteopathic manipulative treatment (OMT) reduces occurrence of gastrointestinal symptoms in premature infants, research suggests.

The study also shows that a high rate of premature infants receiving OMT can be discharged before 28 days, regardless of gender, gestational age, birth weight, and oral feeding at admission.

"Such a result may have important implications for the optimization of health care in premature infants," remark Gianfranco Pizzolorusso (European Institute for Evidence Based Osteopathic Medicine, Chieti, Italy) and colleagues.

"A major proportion of pediatric hospital stays in the United States [are] attributable to neonatal conditions that rank among the most expensive items in the list of services provided for children," they write. The average cost per infant is highest for preterm newborns with gestational age between 24 and 31 weeks, and then for those between 32 and 36 weeks, as opposed to the general population.

The team therefore investigated the effect of OMT on gastrointestinal function and length of stay in a cohort of 350 consecutive premature infants without any major complication admitted to a neonatal intensive care unit between 2005 and 2008.

A total of 188 infants were assigned to receive routine neonatal care, while 162 received routine care plus OMT. Those in the OMT group received osteopathic care within 14 days of birth. Treatment lasted between 20 and 30 minutes, and OMT techniques included indirect myofascial, sutural spread, balanced membranous tension, and balanced ligamentous tension.

Study endpoints were differences in excessive length of stay (=28 days) and gastrointestinal symptoms (episodes of vomit, regurgitation, gastric residual, and enema), defined as the upper quartiles of the overall study population, between groups.

As reported in Chiropractic and Manual Therapies, baseline characteristics were similar between the treated and control groups, except for the rate of infants unable to be oral fed at admission, which was significantly higher among those undergoing osteopathic care.

For infants with an average daily occurrence of gut symptoms above 0.44 at baseline, OMT was independently associated with a 55% reduction in gastrointestinal symptoms.

Gestational age of 32 weeks or less, birth weight lower or equal to 1700 g, and no milk consumption at admission were all associated with significantly increased rates of excessive length of stay. However, OMT reduced this by a significant 78%.

The researchers conclude that randomized control studies are needed to confirm these results and to generalize them to a broader population of high risk newborns.

By Nikki Withers

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