Objective To describe the growth trajectory of children with congenital diaphragmatic hernia (CDH) during the first year, to assess the risk factors for growth failure (GF) at 1 year and to determine nutritional intakes at discharge required for early optimal growth. Design Single-centre retrospective cohort study based on data from a structured follow-up programme. Setting and patients All neonates with CDH (2013–2019) alive at discharge and followed up to age 1. Interventions None. Main outcome measures Weight-for-age z-score (WAZ) at birth, 3, 6 and 12 months of age; risk factors for GF at age 1; energy and protein intake of infants achieving early optimal growth. Results Sixty-three of 65 neonates who were alive at discharge were included. Seven (11%) had GF at 1 year and 3 (4.8%) had a gastrostomy tube. The mean WAZ decreased in the first 3 months before catching up at 1 year (−0.6±0.78). Children with a severe form or born preterm experienced a deeper loss (from −1.5 to −2 z-scores) with late and limited catch-up. The median energy intake required to achieve positive or null weight growth velocity differed significantly according to CDH severity, ranging from 100 kcal/kg/day (postnatal forms) to 139 kcal/kg/day (severe prenatal forms) (p=0.009). Conclusions Growth patterns of CDH infants suggest that nutritional risk stratification and feeding practices may influence growth outcomes. Our results support individualised and active nutritional management based on CDH severity, with energy requirements as high as 140% of recommended intakes for healthy term infants. All data relevant to the study are included in the article or uploaded as supplementary information.

中文翻译：

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先天性膈疝婴儿第一年的生长轨迹和最佳生长的早期营养需求：一项回顾性队列研究

目的 描述先天性膈疝（CDH）儿童第一年的生长轨迹，评估第一年生长障碍（GF）的危险因素，并确定出院时早期最佳生长所需的营养摄入量。根据结构化随访计划的数据设计单中心回顾性队列研究。环境和患者 所有 CDH 新生儿（2013-2019 年）在出院时均存活并随访至 1 岁。干预措施 无。主要结果测量出生时、3、6 和 12 个月时的年龄别体重 z 分数 (WAZ)；1 岁时发生 GF 的危险因素；婴儿的能量和蛋白质摄入量实现早期最佳生长。结果 65 名出院时存活的新生儿中有 63 名被纳入。7 名 (11%) 在 1 岁时接受了 GF，3 名 (4.8%) 接受了胃造口管。平均 WAZ 在前 3 个月内下降，然后在 1 年时追上 (−0.6±0.78)。患有严重形式或早产的儿童经历了更严重的损失（从 -1.5 到 -2 z 分数），且追赶较晚且有限。根据 CDH 的严重程度，达到正体重增长速度或零体重增长速度所需的中位能量摄入量存在显着差异，范围从 100 kcal/kg/天（产后形式）到 139 kcal/kg/天（严重产前形式）（p=0.009）。结论 CDH 婴儿的生长模式表明营养风险分层和喂养方式可能会影响生长结果。我们的结果支持根据 CDH 严重程度进行个性化和积极的营养管理，健康足月婴儿的能量需求高达建议摄入量的 140%。与研究相关的所有数据都包含在文章中或作为补充信息上传。