{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T16:26:39Z","timestamp":1791822399653,"version":"4.3.4"},"reference-count":34,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2009,8,1]],"date-time":"2009-08-01T00:00:00Z","timestamp":1249084800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. pediatr. gastroenterol. nutr."],"published-print":{"date-parts":[[2009,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background:<\/jats:title><jats:p>Growth failure and undernutrition complicate the clinical course of girls with Rett syndrome (RTT). These abnormalities are, in part, the consequence of oral motor dysfunction and inadequate dietary intake.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective:<\/jats:title><jats:p>To determine whether gastrostomy placement for nutritional therapy alters the natural history of growth failure and undernutrition in RTT.<\/jats:p><\/jats:sec><jats:sec><jats:title>Hypothesis:<\/jats:title><jats:p>We hypothesized that gastrostomy placement for nutritional therapy reverses the decline in height, weight, and body mass index (BMI) <jats:italic>z<\/jats:italic> scores in RTT.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods:<\/jats:title><jats:p>Standard stadiometric and anthropometric measures were obtained to derive height, weight, and BMI <jats:italic>z<\/jats:italic> scores and estimates of fat\u2010free mass (FFM) and body fat in a cohort of girls (n = 92) with RTT before and after gastrostomy placement. Methyl\u2010CpG\u2010binding protein 2 (<jats:italic>MECP2<\/jats:italic>) mutations and the presence or absence of a fundoplication were recorded.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results:<\/jats:title><jats:p>The differences in height (n = 73), weight (n = 81), and BMI (n = 81) <jats:italic>z<\/jats:italic> score slopes before and after gastrostomy placement were 1.31 <jats:styled-content>+<\/jats:styled-content> 2.06 (<jats:italic>P<\/jats:italic> &lt; 0.001), 2.38 \u00b1 3.18 (<jats:italic>P<\/jats:italic> &lt; 0.001), and 3.25 \u00b1 3.32 (<jats:italic>P<\/jats:italic> &lt; 0.001), respectively. FFM and body fat (n = 43) increased after gastrostomy by 41 \u00b1 27 g\/cm height (<jats:italic>P<\/jats:italic> &lt; 0.001) and 7.5% \u00b1 5.7% body weight (<jats:italic>P<\/jats:italic> &lt; 0.001), respectively. The differences in height, weight, and BMI <jats:italic>z<\/jats:italic> score slopes were similar regardless of the age at which the gastrostomy was placed. The differences in height, weight, and BMI <jats:italic>z<\/jats:italic> score slopes, as well as the change in FFM and body fat deposition after gastrostomy placement, did not differ between those who did or did not have a fundoplication and among the classes of <jats:italic>MECP2<\/jats:italic> mutations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion:<\/jats:title><jats:p>Gastrostomy placement for aggressive nutritional therapy favorably altered the natural history of growth failure and undernutrition in RTT, but did not restore height and weight <jats:italic>z<\/jats:italic> scores to birth values, regardless of the age at which surgery occurred and in the presence or absence of a fundoplication.<\/jats:p><\/jats:sec>","DOI":"10.1097\/mpg.0b013e31818f61fd","type":"journal-article","created":{"date-parts":[[2009,7,16]],"date-time":"2009-07-16T07:21:05Z","timestamp":1247728865000},"page":"237-242","source":"Crossref","is-referenced-by-count":35,"title":["Gastrostomy Placement Improves Height and Weight Gain in Girls With Rett Syndrome"],"prefix":"10.1002","volume":"49","author":[{"given":"Kathleen J","family":"Motil","sequence":"first","affiliation":[{"name":"USDA\/ARS Children's Nutrition Research Center USA"},{"name":"Department of Pediatrics USA"},{"name":"Texas Children's Hospital USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Morrissey","sequence":"additional","affiliation":[{"name":"Department of Pediatrics USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erwin","family":"Caeg","sequence":"additional","affiliation":[{"name":"Department of Pediatrics USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judy O","family":"Barrish","sequence":"additional","affiliation":[{"name":"Department of Pediatrics USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel G","family":"Glaze","sequence":"additional","affiliation":[{"name":"Department of Pediatrics USA"},{"name":"Texas Children's Hospital USA"},{"name":"Department of Neurology Baylor College of Medicine Houston TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2009,8]]},"reference":[{"key":"e_1_2_6_2_1","first-page":"633","article-title":"The pattern of growth failure in Rett syndrome","volume":"147","author":"Schultz RJ","year":"1993","journal-title":"Am J Dis Child"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/1531-8249(200005)47:5<670::AID-ANA20>3.0.CO;2-F"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-8749.1986.tb03924.x"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajmg.1320420114"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005176-199907000-00010"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(98)70436-6"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajmg.1320250511"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF00688098"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/0887-8994(89)90031-3"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1159\/000184309"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(73)93276-5"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1053\/ejpn.2002.0612"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1136\/jmg.2007.049452"},{"key":"e_1_2_6_15_1","unstructured":"U.S. Department of Health and Human Services. 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