Prevalence, risk factors and parental perceptions of gastroesophageal reflux disease in Asian infants in Singapore

Prevalence, risk factors and parental perceptions of gastroesophageal reflux disease in Asian infants in Singapore

Annals of the Academy of Medicine, Singapore

10.47102/annals-acadmedsg.2021411

http://dx.doi.org/10.47102/annals-acadmedsg.2021411

Vanessa ZY McLoughlin, Noor HA Suaini, Kewin Siah, Evelyn XL Loo, Wei Wei Pang, Yap Seng Chong, Keith M Godfrey, Kok Hian Tan, Jerry KY Chan, Anne EN Goh, Bee Wah Lee, Lynette P Shek, Johan G Eriksson, Marion M Aw, Elizabeth H Tham

30 May 2022

McLoughlin, V. Z., Suaini, N. H., Siah, K., Loo, E. X., Pang, W. W., Chong, Y. S., Godfrey, K. M., Tan, K. H., Chan, J. K., Goh, A. E., Lee, B. W., Shek, L. P., Eriksson, J. G., Aw, M. M., & Tham, E. H. (2022). Prevalence, risk factors and parental perceptions of gastroesophageal reflux disease in Asian infants in Singapore. Annals of the Academy of Medicine, Singapore, 51(5), 263–271. https://doi.org/10.47102/annals-acadmedsg.2021411

Introduction: Infant gastroesophageal reflux disease (GERD) is a significant cause of concern to parents. This study seeks to describe GERD prevalence in infants, evaluate possible risk factors and assess common beliefs influencing management of GERD among Asian parents. Methods: Mother-infant dyads in the Singapore PREconception Study of long-Term maternal and child Outcomes (S-PRESTO) cohort were prospectively followed from preconception to 12 months post-delivery. GERD diagnosis was ascertained through the revised Infant Gastroesophageal Reflux Questionnaire (I-GERQ-R) administered at 4 time points during infancy. Data on parental perceptions and lifestyle modifications were also collected. Results: The prevalence of infant GERD peaked at 26.5% at age 6 weeks, decreasing to 1.1% by 12 months. Infants exclusively breastfed at 3 weeks of life had reduced odds of GERD by 1 year (adjusted odds ratio 0.43, 95% confidence interval 0.19–0.97, P=0.04). Elimination of “cold or heaty food” and “gas producing” vegetables, massaging the infant’s abdomen and application of medicated oil to the infant’s abdomen were quoted as major lifestyle modifications in response to GERD symptoms. Conclusion: Prevalence of GERD in infants is highest in the first 3 months of life, and the majority outgrow it by 1 year of age. Infants exclusively breastfed at 3 weeks had reduced odds of GERD. Cultural-based changes such as elimination of “heaty or cold” food influence parental perceptions in GERD, which are unique to the Asian population. Understanding the cultural basis for parental perceptions and health-seeking behaviours is crucial in tailoring patient education appropriately for optimal management of infant GERD. Keywords: Gastroenterology, gastrointestinal disorders, GERD, infant feeding, parental beliefs

Publisher Copyright

This research / project is supported by the National Medical Research Council - Translational and Clinical Research (TCR) Flagship Programme
Grant Reference no. : NMRC/TCR/004-NUS/2008

This research / project is supported by the National Medical Research Council - Translational and Clinical Research (TCR) Flagship Programme
Grant Reference no. : NMRC/TCR/012-NUHS/2014

This research / project is supported by the National Medical Research Council (NMRC) - Research Training Fellowship grant
Grant Reference no. : MH 095:003\008- 225

This research / project is supported by the National Medical Research Council (NMRC) - Transition Award
Grant Reference no. : MOH-000269

This research is supported by core funding from: Singapore Institute for Clinical Sciences
Grant Reference no. : N.A

Supported by the UK Medical Research Council (MC_UU_12011/4), the National Institute for Health Research (NIHR Senior Investigator [NF-SI-0515- 10042] and NIHR Southampton Biomedical Research Centre [IS-BRC-1215-20004]) and the European Union (Erasmus+ Programme ImpENSA 598488-EPP-1-2018-1-DE-EPPKA2-CBHE-JP), Rokos Scholarship from Pembroke College, University of Oxford, UK and by SICS.

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Singapore Institute for Clinical Sciences