Related Experiment Videos
Ontogeny of pancreatic exocrine function
S Kolacek1, J W Puntis, D R Lloyd
1Institute of Child Health, University of Birmingham.
Insights
Preterm infants show similar pancreatic chymotrypsin levels at birth as term infants. However, pancreatic exocrine function initiation is slower in preterm infants, with lower levels in those small for gestational age.
Area of Science:
- Neonatal physiology
- Gastroenterology
- Pediatric nutrition
Background:
- Exocrine pancreatic function is crucial for infant nutrition and growth.
- Assessing pancreatic function in preterm infants is important for understanding their developmental trajectory.
- Faecal chymotrypsin concentration is a reliable marker for exocrine pancreatic proteolytic activity.
Purpose of the Study:
- To investigate exocrine pancreatic proteolytic activity in preterm infants during the first 28 days of life.
- To compare pancreatic function between preterm infants who are small for gestational age (SGA) and appropriate for gestational age (AGA).
- To determine the impact of intrauterine growth retardation on pancreatic exocrine function in preterm neonates.
Main Methods:
- Serial measurement of faecal chymotrypsin concentration in 21 preterm infants (23-32 weeks' gestation).
- Data collected during the first 28 days of life.
- Statistical comparison of chymotrypsin concentrations between SGA and AGA infants.
Main Results:
- Overall faecal chymotrypsin concentration range was similar to term infants, indicating well-developed secretion at birth.
- A delay in the typical chymotrypsin concentration peak was observed, occurring around day 8 instead of day 4.
- Median faecal chymotrypsin concentrations were significantly lower in infants who were small for gestational age compared to appropriate for gestational age infants.
Conclusions:
- Pancreatic chymotrypsin secretion is developed at birth in preterm infants, but its functional initiation may be slower.
- Intrauterine growth retardation appears to negatively impact pancreatic exocrine function in preterm infants.
- Impaired pancreatic exocrine function in SGA preterm infants may hinder postnatal growth and catch-up growth.
Abstract:
Exocrine pancreatic proteolytic activity, determined by serial measurement of faecal chymotrypsin concentration, was investigated in 21 preterm infants (23-32 weeks' gestation) during the first 28 days of life. The overall chymotrypsin concentration range was similar to that already described in term infants showing that pancreatic chymotrypsin secretion is equally well developed at birth in the preterm infant. A chymotrypsin concentration peak, seen in term infants at 4 days, did not occur in this study until day 8, suggesting a slower initiation of pancreatic exocrine function in the preterm infant. Median faecal chymotrypsin concentrations, calculated for each baby using data from stools passed between day 2 and day 12 of life, were significantly lower in infants who were small for gestational age when compared with those who were an appropriate size for gestational age. The lower chymotrypsin concentration in infants who were small for gestational age suggests a deleterious effect of intrauterine growth retardation on pancreatic exocrine function which may be a factor in limiting postnatal catch up growth.