Ethnicity and Gender Related Differences in Extended Intraesophageal PH Monitoring Parameters in Infants: a Retrospective Study

Overview

Journal BMC Pediatr

Publisher Biomed Central

Specialty Pediatrics

Date 2005 Jul 20

PMID 16026617

Citations 2

Authors

Dena Nazer

Ronald Thomas

Vasundhara Tolia

Affiliations

Soon will be listed here.

Abstract

Background: Gastroesophageal reflux disease (GERD) is believed to be more common in adult males as compared to females. It also has been shown in adults to be more common in Caucasians. We wanted to determine ethnicity and gender related differences for extended pH monitoring parameters in infancy.

Methods: Extended pH monitoring data (EPM) from infants < 1 year of age were reviewed. Results were classified in two groups, as control and Gastroesophageal reflux disease (GERD) group based on the reflux index (RI). The GERD group had RI of equal to or more than 5% of total monitoring period. The parameters of RI, total number of episodes of pH < 4, and the number of episodes with pH < 4 lasting more than 5 minutes were compared by genders and by ethnic groups, Caucasians and African American (AA).

Results: There were 569 infants, 388 controls, 181 with GERD (320 males, 249 females; 165 Caucasians, 375 AA). No statistical difference in EPM parameters was detected between genders in both groups. However, Caucasian infants had a significantly higher incidence of GERD than AA infants (p = 0.036). On stratifying by gender, Caucasian females had a significantly higher number of reflux episodes > 5 minutes as compared to AA females in the control group (p = 0.05). Furthermore, Caucasian females with GERD showed an overall higher trend for all parameters. Caucasian males had a trend for higher mean number of reflux episodes as compared to AA males in the control group (p = 0.09).

Conclusion: Although gender specific control data do not appear warranted in infants undergoing EPM, ethnic differences related to an overall increased incidence of pathologic GERD in Caucasian infants should be noted.

Citing Articles

Sex-specific airway hyperreactivity and sex-specific transcriptome remodeling in neonatal piglets challenged with intra-airway acid.

Reznikov L, Liao Y, Gu T, Davis K, Kuan S, Atanasova K Am J Physiol Lung Cell Mol Physiol. 2018; 316(1):L131-L143.

PMID: 30407862 PMC: 6383496. DOI: 10.1152/ajplung.00417.2018.

Infantile gastroesophageal reflux in a hospital setting.

Baker S, Roach C, Leonard M, Baker R BMC Pediatr. 2008; 8:11.

PMID: 18371208 PMC: 2322969. DOI: 10.1186/1471-2431-8-11.

References

Sondheimer J . Continuous monitoring of distal esophageal pH: a diagnostic test for gastroesophageal reflux in infants. J Pediatr. 1980; 96(5):804-7. DOI: 10.1016/s0022-3476(80)80546-4. View

Tolia V, Wuerth A, Thomas R . Diagnostic interpretation of extended pH monitoring: is there a single best method?. Dig Dis Sci. 2005; 50(1):94-9. DOI: 10.1007/s10620-005-1284-y. View

Orenstein S, Izadnia F, Khan S . Gastroesophageal reflux disease in children. Gastroenterol Clin North Am. 2000; 28(4):947-69. DOI: 10.1016/s0889-8553(05)70099-6. View

Nagy E, Orvos H, Bardos G, Molnar P . Gender-related heart rate differences in human neonates. Pediatr Res. 2000; 47(6):778-80. DOI: 10.1203/00006450-200006000-00016. View

Segal I . The gastro-oesophageal reflux disease complex in sub-Saharan Africa. Eur J Cancer Prev. 2001; 10(3):209-12. DOI: 10.1097/00008469-200106000-00003. View

Vandenplas Y . Continuous 24-hour esophageal pH monitoring in 285 asymptomatic infants 0-15 months old. J Pediatr Gastroenterol Nutr. 1987; 6(2):220-4. DOI: 10.1097/00005176-198703000-00010. View

Tolia V, Kauffman R . Comparison of evaluation of gastroesophageal reflux in infants using different feedings during intraesophageal pH monitoring. J Pediatr Gastroenterol Nutr. 1990; 10(4):426-9. DOI: 10.1097/00005176-199005000-00002. View

Vandenplas Y, LOEB H . The interpretation of oesophageal pH monitoring data. Eur J Pediatr. 1990; 149(9):598-602. DOI: 10.1007/BF02034740. View

Vandenplas Y, Goyvaerts H, Helven R, Sacre L . Gastroesophageal reflux, as measured by 24-hour pH monitoring, in 509 healthy infants screened for risk of sudden infant death syndrome. Pediatrics. 1991; 88(4):834-40. View

10.

Peeters S, Vandenplas Y . Sex ratio of gastroesophageal reflux in infancy. J Pediatr Gastroenterol Nutr. 1991; 13(3):314. DOI: 10.1097/00005176-199110000-00015. View

11.

Richter J, Bradley L, DeMeester T, Wu W . Normal 24-hr ambulatory esophageal pH values. Influence of study center, pH electrode, age, and gender. Dig Dis Sci. 1992; 37(6):849-56. DOI: 10.1007/BF01300382. View

12.

Fass R, Sampliner R, Mackel C, McGee D, Rappaport W . Age- and gender-related differences in 24-hour esophageal pH monitoring of normal subjects. Dig Dis Sci. 1993; 38(10):1926-8. DOI: 10.1007/BF01296120. View

13.

Colletti R, Christie D, Orenstein S . Statement of the North American Society for Pediatric Gastroenterology and Nutrition (NASPGN). Indications for pediatric esophageal pH monitoring. J Pediatr Gastroenterol Nutr. 1995; 21(3):253-62. DOI: 10.1097/00005176-199510000-00002. View

14.

Osatakul S, Sriplung H, Puetpaiboon A, Chamnongpakdi S . Prevalence and natural course of gastroesophageal reflux symptoms: a 1-year cohort study in Thai infants. J Pediatr Gastroenterol Nutr. 2001; 34(1):63-7. DOI: 10.1097/00005176-200201000-00015. View

15.

Spechler S, Jain S, Tendler D, Parker R . Racial differences in the frequency of symptoms and complications of gastro-oesophageal reflux disease. Aliment Pharmacol Ther. 2002; 16(10):1795-800. DOI: 10.1046/j.1365-2036.2002.01351.x. View

16.

Rerksuppaphol S, Barnes G . Guidelines for evaluation and treatment of gastroesophageal reflux in infants and children: recommendations of the North American Society for Pediatric Gastroenterology and Nutrition. J Pediatr Gastroenterol Nutr. 2002; 35(4):583. DOI: 10.1097/00005176-200210000-00024. View

17.

Nilsson M, Johnsen R, Ye W, Hveem K, Lagergren J . Obesity and estrogen as risk factors for gastroesophageal reflux symptoms. JAMA. 2003; 290(1):66-72. DOI: 10.1001/jama.290.1.66. View

18.

Lavizzo-Mourey R, Knickman J . Racial disparities--the need for research and action. N Engl J Med. 2003; 349(14):1379-80. DOI: 10.1056/NEJMe030090. View

19.

Tolia V, Wuerth A, Thomas R . Gastroesophageal reflux disease: review of presenting symptoms, evaluation, management, and outcome in infants. Dig Dis Sci. 2003; 48(9):1723-9. DOI: 10.1023/a:1025486710231. View

20.

Strobel C, Byrne W, Ament M, Euler A . Correlation of esophageal lengths in children with height: application to the Tuttle test without prior esophageal manometry. J Pediatr. 1979; 94(1):81-4. DOI: 10.1016/s0022-3476(79)80361-3. View