Frontiers in pediatrics
Outcomes of gastrostomy in children with neurological impairment: a systematic review
By Ibrahim MK, Jummakhan H, Dawood M and 6 others.
Abstract
Introduction
Gastrostomy feeding is widely used for children with neurological impairment and inadequate oral intake, but evidence across family-important outcomes has not been synthesised. Previous systematic reviews were restricted to cerebral palsy and found no controlled studies. The objective of this study is to assess gastrostomy vs. continued oral/nasogastric feeding on nutritional, respiratory, neurodevelopmental, and caregiver-reported outcomes, and to quantify complications.
Methods
A PROSPERO-registered systematic review (CRD420261483110) was conducted following PRISMA 2020 guidelines. Five databases were searched to 15 July 2026 for children aged 0-18 with neurological impairment undergoing gastrostomy. Duplicate screening, data extraction, and risk-of-bias appraisal (RoB 2, ROBINS-I, JBI, CASP) were performed. Heterogeneity precluded meta-analysis; narrative synthesis prioritized study design and methodological quality over direction-of-effect vote counting.