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Preterm birth makes the immature intestine sensitive to feeding-induced intestinal atrophy

Charlotte Reinhard Bjornvad1, Mette Schmidt, Yvette Miata Petersen

  • 1Department of Human Nutrition, Royal Veterinary and Agricultural University, Rolighedsvej 30, DK-1958 Frederiksberg C., Denmark.

American Journal of Physiology. Regulatory, Integrative and Comparative Physiology
|June 18, 2005
PubMed

Insights

Preterm birth and formula feeding can harm the immature gut, increasing necrotizing enterocolitis (NEC) risk. However, intestinal development is not birth-dependent, but preterm birth factors with suboptimal diets increase NEC vulnerability.

Area of Science:

  • Neonatal physiology
  • Gastroenterology
  • Developmental biology

Background:

  • Preterm birth and formula feeding are risk factors for small intestinal dysfunction and necrotizing enterocolitis (NEC).
  • The impact of birth-related physiological and environmental changes on the immature intestine's response to feeding is not fully understood.

Purpose of the Study:

  • To investigate how physiological and environmental transitions at birth influence the immature intestine's response to enteral feeding in piglets.
  • To compare the effects of in-utero feeding versus postnatal feeding with either sow's colostrum or infant formula.

Main Methods:

  • Pig fetuses were fed sow's colostrum or infant formula in utero via esophageal tubes.
  • Postnatally, fetuses were delivered and their gastrointestinal morphology and function compared with preterm newborn littermates fed colostrum or formula.
  • Measurements included intestinal mass, brush-border enzyme activities, plasma glucagon-like peptide 2, enterocyte function, and antioxidative capacity.

Main Results:

  • In-utero feeding with either colostrum or formula increased intestinal mass and enzyme activity to levels similar to colostrum-fed newborns.
  • Postnatal formula feeding in preterm piglets led to reduced intestinal growth, decreased enzyme activity, intestinal lesions (NEC), impaired enterocyte function, and reduced antioxidative capacity.
  • Brush-border enzyme mRNA levels were not significantly different between formula-fed and colostrum-fed preterm piglets.

Conclusions:

  • Feeding-induced growth and enzyme maturation of the immature intestine are not dependent on the timing of birth.
  • Suboptimal diets (infant formula) combined with factors of preterm birth (microbial, metabolic, endocrine changes) sensitize the immature intestine to atrophy and NEC development.

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