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Relations between feeding intolerance and stress biomarkers in preterm infants

Tiffany A Moore1, Margaret E Wilson, Kendra K Schmid

  • 1College of Nursing, University of Nebraska Medical Center, Omaha, NE 68198-5330, USA.

Journal of Pediatric Gastroenterology and Nutrition
|April 12, 2013
PubMed

Insights

Feeding intolerance in preterm infants may be linked to stress. Biomarker differences in cortisol and 8-hydroxydeoxyguanosine (8-OHdG) were observed between infants with and without feeding intolerance.

Area of Science:

  • Neonatal physiology
  • Stress biomarkers
  • Gastrointestinal disorders

Background:

  • Feeding intolerance (FI) is a common complication in preterm infants, with unclear etiology.
  • This study investigates FI as a stress-related condition involving brain-gut interactions and the allostatic load model.

Purpose of the Study:

  • To describe demographic and medical variables and biomarker levels in preterm infants.
  • To compare these variables and biomarker levels between infants with and without FI.
  • To compare biomarker distributions (interquartile/interpercentile) between infants with and without FI.

Main Methods:

  • Recruited preterm infants (<32 weeks' gestation).
  • Defined FI as feeding intolerance by day 7.
  • Operationalized allostatic load using cortisol and 8-hydroxydeoxyguanosine (8-OHdG) from cord blood, saliva, and urine on days 1, 7, and 14.

Main Results:

  • Seven of 31 infants developed FI.
  • Infants with FI showed lower median urinary cortisol on day 1 and trended lower in cord blood cortisol.
  • Significant differences in biomarker distributions (cortisol, 8-OHdG) were found between groups on days 1 and 14.

Conclusions:

  • Findings support the allostatic load model for FI in preterm infants.
  • Further research should investigate cellular mechanisms and prenatal factors.
  • Larger sample sizes are recommended for future studies.
Abstract

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