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Gestational maturation of electrical activity of the stomach
S Cucchiara1, G Salvia, A Scarcella
1Department of Pediatrics, University of Naples Federico II, Italy.
Insights
Gastric electrical activity in preterm infants matures with advancing postnatal age, detectable via noninvasive electrogastrography. A normal gastric rhythm emerges by 35 weeks gestation, indicating readiness for feeding.
Area of Science:
- Neonatal Physiology
- Gastrointestinal Motility Development
- Electrophysiology
Background:
- Maturation of gastrointestinal motility is crucial for preterm neonates' ability to tolerate enteral nutrition.
- Gastric motility is primarily regulated by the electrical activity of smooth muscle cells.
- Understanding the developmental trajectory of gastric electrical activity is essential for assessing neonatal gastrointestinal function.
Purpose of the Study:
- To investigate the developmental changes in gastric electrical activity in preterm infants.
- To assess the utility of cutaneous electrogastrography (EGG) as a noninvasive tool for monitoring gastric electrical activity maturation.
- To compare gastric electrical activity patterns in preterm and full-term infants.
Main Methods:
- Weekly cutaneous electrogastrography (EGG) recordings were performed for 1 hour before and after meals in 27 preterm infants (29-34 weeks gestation).
- Key EGG variables measured included percentage of normal gastric rhythm (2-4 cpm), percentage of tachygastria (>4 cpm), fed-to-fasting ratio of dominant power, and dominant frequency instability.
- Data were compared with recordings from 10 full-term infants.
Main Results:
- A normal gastric rhythm (2-4 cpm) was present in most recordings across all gestational ages studied.
- By 35 weeks gestation, preterm infants showed percentages of normal rhythm and tachygastria similar to full-term infants.
- Gastric electrical activity showed a significant increase in power post-meal across all gestational ages, and instability normalized by 35 weeks.
Conclusions:
- Cutaneous electrogastrography is a viable noninvasive method for detecting maturation patterns in neonatal gastric electrical activity.
- While normal electrical rhythm is detectable early, it becomes dominant around 35 weeks of gestational age.
- Developmental changes in gastric electrical activity in preterm infants correlate with advancing postnatal age.
Abstract:
Gestational maturation of gastrointestinal motility is a key factor in readiness of the preterm neonates for enteral nutrition. Since gastric motility mainly depends on the electrical activity of the smooth muscle cells, it was of interest to investigate the developmental aspects of electrical activity of the stomach. The latter was recorded weekly through cutaneous electrogastrography in 27 preterm infants (aged 29-34 weeks of gestation). Recordings were done for 1 hr before and 1 hr after meal. The electrogastrographic variables measured were: percentage of normal gastric rhythm, ie, 2-4 cpm; percentage of tachygastria (>4 cpm); the fed-to-fasting ratio of the dominant electrogastrographic power; and the instability coefficient of the dominant frequency. Data were compared with those measured in 10 full-term infants. Peaks of normal electrical activity (2-4 cpm) were present in most of the recordings at all the gestational ages; however, percentages of both normal electrical rhythm and tachygastria in preterm infants were similar to those measured in full-term infants (mean +/- SD) (normal rhythm; fasting: 70.2 +/- 3.8, fed: 72.2 +/- 5.0; tachygastria: fasting: 24.6 +/- 4.0, fed: 19.1 +/- 3.5) by 35 weeks of gestation (normal rhythm; fasting: 67.5 +/- 2.0, fed: 69.6 +/- 4.4; tachygastria: fasting: 27.1 +/- 4.0, fed: 25.6 +/- 4.1). The coefficient of instability of the dominant frequency in preterm infants was also similar to the value measured in full-term infants by 35 weeks of gestation, whereas the EGG power showed a significant increase in the postprandial state at all the gestational ages. We conclude that a maturation pattern of the electrical activity of the stomach can be detected by means of a noninvasive tool such as cutaneous electrogastrography: a normal electrical rhythm can be detected at very early gestational ages; however, this activity becomes dominant at around the 35 weeks of gestational age. In preterm infants developmental changes of gastric electrical activity are a function of advancing postnatal age.