Article Text

Download PDFPDF
Initial treatment and early weight gain of children with Robin Sequence in Germany: a prospective epidemiological study
  1. Christoph Maas,
  2. Christian F Poets
  1. Department of Neonatology, University Hospital, Tuebingen, Germany
  1. Correspondence to Professor Christian F Poets, Department of Neonatology, Tuebingen University Hospital, Calwerstr. 7, Tuebingen 72076, Germany; Christian-f.poets{at}


Background To investigate birth prevalence of Robin Sequence (RS), distribution of implemented treatments and factors influencing weight gain during initial hospitalisation.

Methods Prospective population-based survey (August 2011–July 2013) on new hospital admissions of infants with RS in Germany. RS was defined as retrognathia/micrognathia and at least one of the following: upper airway obstruction, snoring or hypoxaemia; glossoptosis; feeding difficulties; failure to thrive; cleft palate or RS-associated syndrome. Birth prevalence was calculated using data from the National Bureau of Statistics and in-hospital weight gain evaluated by calculating differences in SD scores (SDS) for weight. Comparisons between cohorts were performed using the Wilcoxon/Kruskal–Wallis test or Fisher's exact test.

Results 151 patients with RS could be verified resulting in a birth prevalence of 11.3 per 100 000 live births. Orthodontic therapy (feeding plate or pre-epiglottic baton plate, PEBP) was applied most frequently (107 infants), followed by prone positioning (97 infants). Tracheotomy was rarely performed (n=7). For 115 infants, implementation of more than one intervention was reported. Infants with serious respiratory difficulties during initial hospitalisation (n=58) showed a more pronounced decrease in SDS for weight (median (IQR) −0.81 (−1.32 to −0.26) vs −0.48 (−0.86 to 0.02); p=0.008) whereas treatment with PEBP was associated with better weight gain (SDS-difference for weight −0.37 (−1.06 to 0.02) vs −0.74 (−1.09 to −0.35); p=0.022).

Conclusions Non-surgical management is preferred for infants with RS in Germany. The extent of upper airway obstruction seemed to influence in-hospital weight gain, while use of the PEBP was associated with improved early weight gain.

  • Congenital Abnorm
  • Epidemiology

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.