{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T00:32:08Z","timestamp":1788827528293,"version":"build-2803163510"},"reference-count":32,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2020,11,14]],"date-time":"2020-11-14T00:00:00Z","timestamp":1605312000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Background: Long-term negative sequelae of esophageal atresia (EA) may induce poor growth and impaired nutritional status in childhood. We describe the nutritional profile and energy metabolism of children with repaired EA to identify malnutrition risk factors and optimize growth management. Methods: Twenty-one children (&gt;4 years) were included, and anthropometric measurements, nutritional assessment, and energy metabolism were considered. The subjects were defined as undernourished if they met BMI &lt; \u22122 standard deviation (SD). To grade undernutrition, we defined the prevalence of underweight, stunting, and wasting (cut-off level of &lt;\u22122 SD). Medical records were reviewed for the type of EA and surgery and perinatal data. Results: Malnutrition was detected in 28.6% of children. Underweight was detected in 23.8% of patients (all with undernutrition p &lt; 0.01). Wasting was noted in 28.6% of patients, of these 5 children were undernourished (p &lt; 0.001) and stunting was noticed in only one patient with malnutrition (p = 0.5). Resting expenditure energy (REE) was lower in undernourished subjects compared to subjects with adequate nutritional status (p &lt; 0.001). Malnutrition was associated to: type of EA (p = 0.003, particularly type A and C); intervention including deferred anastomosis due to long-gap repair (p = 0.04) with\/or without jejunostomy (p = 0.02), gastric pull-up (p = 0.04), primary anastomosis (p = 0.04), pyloromyotomy in long-gap (p &lt; 0.01); small for gestational age condition (p = 0.001). Conclusions: undernutrition risk factors, beyond the type of malformation, surgery, and perinatal factors, must be early considered to personalize nutritional programming. Energy metabolism is important to monitor the nutritional requirements. The management of nutritional issues is surely a contributory factor able to counteract the poor growth of children with EA.<\/jats:p>","DOI":"10.3390\/children7110228","type":"journal-article","created":{"date-parts":[[2020,11,16]],"date-time":"2020-11-16T11:04:20Z","timestamp":1605524660000},"page":"228","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Esophageal Atresia: Nutritional Status and Energy Metabolism to Maximize Growth Outcome"],"prefix":"10.3390","volume":"7","author":[{"given":"Gloria","family":"Pelizzo","sequence":"first","affiliation":[{"name":"Pediatric Surgery Department, \u201cV. Buzzi\u201d Children\u2019s Hospital, 20157 Milano, Italy"},{"name":"Department of Biomedical and Clinical Science \u201cL. Sacco\u201d, University of Milano, 20157 Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0206-2892","authenticated-orcid":false,"given":"Francesca","family":"Destro","sequence":"additional","affiliation":[{"name":"Pediatric Surgery Department, \u201cV. Buzzi\u201d Children\u2019s Hospital, 20157 Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giorgio Giuseppe Orlando","family":"Selvaggio","sequence":"additional","affiliation":[{"name":"Pediatric Surgery Department, \u201cV. Buzzi\u201d Children\u2019s Hospital, 20157 Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luciano","family":"Maestri","sequence":"additional","affiliation":[{"name":"Pediatric Surgery Department, \u201cV. Buzzi\u201d Children\u2019s Hospital, 20157 Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margherita","family":"Roveri","sequence":"additional","affiliation":[{"name":"Pediatric Surgery Department, \u201cV. Buzzi\u201d Children\u2019s Hospital, 20157 Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandra","family":"Bosetti","sequence":"additional","affiliation":[{"name":"Pediatric Department, \u201cV. Buzzi\u201d Children\u2019s Hospital, 20157 Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0750-9451","authenticated-orcid":false,"given":"Barbara","family":"Borsani","sequence":"additional","affiliation":[{"name":"Pediatric Department, \u201cV. Buzzi\u201d Children\u2019s Hospital, 20157 Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erica","family":"Pendezza","sequence":"additional","affiliation":[{"name":"Pediatric Department, \u201cV. Buzzi\u201d Children\u2019s Hospital, 20157 Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Milena","family":"Meroni","sequence":"additional","affiliation":[{"name":"Pediatric Surgery Department, \u201cV. Buzzi\u201d Children\u2019s Hospital, 20157 Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Pansini","sequence":"additional","affiliation":[{"name":"Pediatric Surgery Department, \u201cV. Buzzi\u201d Children\u2019s Hospital, 20157 Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enrico","family":"La Pergola","sequence":"additional","affiliation":[{"name":"Pediatric Surgery Department, \u201cV. Buzzi\u201d Children\u2019s Hospital, 20157 Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7885-2524","authenticated-orcid":false,"given":"Giovanna","family":"Riccipetitoni","sequence":"additional","affiliation":[{"name":"Pediatric Surgery Unit, Fondazione IRCCS Policlinico S. Matteo, 27100 Pavia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3128-8441","authenticated-orcid":false,"given":"Annalisa","family":"De Silvestri","sequence":"additional","affiliation":[{"name":"Clinical Epidemiology &amp; Biometry, IRCCS Policlinico San Matteo Foundation, 27100 Pavia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5752-6199","authenticated-orcid":false,"given":"Hellas","family":"Cena","sequence":"additional","affiliation":[{"name":"Laboratory of Dietetics and Clinical Nutrition, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy"},{"name":"Clinical Nutrition and Dietetics Service, Unit of Internal Medicine and Endocrinology, ICS Maugeri IRCCS, 27100 Pavia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2137-5974","authenticated-orcid":false,"given":"Valeria","family":"Calcaterra","sequence":"additional","affiliation":[{"name":"Pediatric Department, \u201cV. Buzzi\u201d Children\u2019s Hospital, 20157 Milano, Italy"},{"name":"Pediatric and Adolescent Unit. Department of Internal Medicine, University of Pavia, 27100 Pavia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2020,11,14]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"893","DOI":"10.1002\/bdra.23067","article-title":"Prevalence of esophageal atresia among 18 international birth defects surveillance programs","volume":"94","author":"Nassar","year":"2012","journal-title":"Birth Defects Res. Part A Clin. Mol. Teratol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1007\/s00383-011-3014-1","article-title":"Aspects of esophageal atresia in a population-based setting: Incidence, mortality, and cancer risk","volume":"28","author":"Oddsberg","year":"2011","journal-title":"Pediatr. Surg. 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