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Patterns of antropyloric motility in fed healthy preterm infants
B B Hassan1, R Butler, G P Davidson
1Centre for Paediatric and Adolescent Gastroenterology, Women's and Children's Hospital, North Adelaide, SA 5006, Australia.
Insights
Antropyloric motility patterns in premature infants were evaluated using micromanometry. Findings show coordinated gastric emptying mechanisms are well-developed by 30 weeks postmenstrual age, crucial for infant feeding.
Area of Science:
- Neonatology
- Gastroenterology
- Physiology
Background:
- Antropyloric motility is key for gastric emptying.
- Characterization of this motility in premature infants is limited.
Purpose of the Study:
- To evaluate fed patterns of antropyloric motility in premature infants.
- To assess the development of neuroregulatory mechanisms for gastric emptying.
Main Methods:
- Utilized a micromanometric feeding assembly with a pyloric sleeve sensor.
- Measured postprandial antropyloric motility in 43 healthy premature infants (30-38 weeks postmenstrual age).
- Characterized isolated pyloric pressure waves (IPPWs) and antral pressure wave sequences (PWSs) based on propagation direction.
Main Results:
- Recorded 7289 pressure wave events: 48% IPPWs, 52% PWSs.
- IPPWS predominated in the first postprandial hour, PWSs after one hour.
- Mean half gastric emptying time was 42 minutes.
Conclusions:
- Antropyloric motor patterns in premature infants suggest well-developed neuroregulatory mechanisms.
- Coordination of motility and gastric emptying is established by 30 weeks postmenstrual age.
Background:
Antropyloric motility is important for regulation of gastric emptying and has not been adequately characterised in premature infants.
Aim:
To evaluate fed patterns of antropyloric motility in premature infants.
Subjects:
Forty three healthy premature infants, 30-38 weeks of postmenstrual age.
Methods:
Postprandial antropyloric motility was measured using a micromanometric feeding assembly (outer diameter 1.8 mm) incorporating a pyloric sleeve sensor. The occurrence of isolated pyloric pressure waves (IPPWs) and antral pressure wave sequences (PWSs) was characterised. Sequences were further classified as being antegrade, synchronous, antegrade-synchronous, and retrograde according to the direction of propagation.
Results:
A total of 7289 pressure wave events were recorded, 48% IPPWs and 52% PWSs (18% antegrade, 12% synchronous, 13% antegrade-synchronous, 2% retrograde, and 7% undefined). IPPWs predominated in the first postprandial hour, peaking at 30-60 minutes. PWSs predominated in the period after one hour postprandially. Mean (SEM) half gastric emptying time was 42 (4) minutes.
Conclusions:
Monitoring of antropyloric motor patterns in healthy premature infants indicates that the neuroregulatory mechanisms responsible for the coordination of antropyloric motility and gastric emptying are well developed by 30 weeks of postmenstrual age.