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Early gastrointestinal function and nutritional status in preterm infants with cystic periventricular leukomalacia
Masanori Murase1, Akihito Ishida, Tetsuya Momota
1Department of Pediatrics, Kakogawa Municipal Hospital, Kakogawa, Hyougo, Japan.
Insights
Very low birth weight infants with cystic periventricular leukomalacia show impaired early gastrointestinal function and reduced nutritional intake compared to healthy infants.
Area of Science:
- Neonatology
- Pediatric Gastroenterology
- Neurodevelopmental Pediatrics
Background:
- Cystic periventricular leukomalacia (PVL) is a serious brain injury in preterm infants.
- Early gastrointestinal (GI) function and nutritional status are critical for VLBW infant outcomes.
Purpose of the Study:
- To investigate early GI function and nutritional status in very low birth weight (VLBW) infants with cystic PVL.
- To compare these parameters between VLBW infants with and without PVL.
Main Methods:
- Retrospective study of 65 VLBW infants (5 PVL group, 60 normal group).
- Analysis of gastric aspirates, abdominal radiographs, and superior mesenteric artery (SMA) Doppler ultrasonography.
- Comparison of GI function and nutritional intake within the first 1-2 weeks of life.
Main Results:
- PVL infants had more gastric residual fluids and abnormal abdominal radiographs.
- Higher SMA peak systolic and time-averaged velocities were observed in PVL infants.
- PVL infants had significantly lower milk intake and energy intake in the first two weeks.
Conclusions:
- VLBW infants with cystic PVL exhibit significantly impaired early gastrointestinal function.
- Nutritional intake is notably inferior in PVL infants during the early neonatal period.
- These findings highlight potential challenges in feeding and growth for VLBW infants with PVL.
Objective:
To retrospectively investigate the early gastrointestinal function and the nutritional status of very low birth weight (VLBW) infants with cystic periventricular leukomalacia (PVL).
Methods:
Sixty-five VLBW infants who were admitted to Kakogawa Municipal Hospital were divided into 2 groups: 5 infants were in the PVL group, and the remaining 60 infants were in the normal group. The gastrointestinal function of the infants in the early neonatal period was compared between the 2 groups using an analysis of gastric aspirates and abdominal radiographs, and pulsed-Doppler ultrasonographic measurement of the flow velocity in the superior mesenteric artery (SMA).
Results:
In the first week, there were more days in which abdominal gastric residual fluids occurred in the PVL group than in the normal group. The occurrence of abnormal findings in the abdominal radiograph within the first 7 days was significantly higher in the PVL group than in the normal group. Longitudinal ultrasonographic comparisons of the SMA flow velocity showed that the mean values in peak systolic velocity and in time-averaged velocity were both significantly higher in the PVL group than in the normal group before 7 days of life. Both the total volume of milk ingested and the total energy intake in the PVL group were significantly lower than in the normal group within the first 2 weeks of life.
Conclusions:
Despite the low number of infants with PVL, we may suggest that the gastrointestinal function of the preterm infants with cystic PVL may deteriorate significantly compared to normal infants in the early neonatal period of life, and consequently, the early nutritional intakes in the PVL infants are inferior to those in the normal infants.