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Pharyngeal stimulus-induced reflexes are impaired in infants with perinatal asphyxia: Does maturation modify?

P S Jensen1,2, I K Gulati1,2, T R Shubert1

  • 1Neonatal and Infant Feeding Disorders Program, The Research Institute at Nationwide Children's Hospital, Columbus, OH, USA.

Neurogastroenterology and Motility
|March 4, 2017
PubMed

Insights

Infants with hypoxic ischemic encephalopathy (HIE) show impaired pharyngeal reflexes and abnormal muscle function compared to controls. These issues worsen with maturation, potentially causing feeding and reflux problems.

Area of Science:

  • Pediatric neurology
  • Gastroenterology
  • Developmental neuroscience

Background:

  • Pharyngo-esophageal protective reflexes in infants with hypoxic ischemic encephalopathy (HIE) are not well understood.
  • Investigating these reflexes and their maturation in HIE infants is crucial.

Purpose of the Study:

  • To differentiate pharyngo-esophageal protective reflexes in HIE infants from those in healthy controls.
  • To examine maturational changes in these reflexes within HIE infants.

Main Methods:

  • Evaluated 14 HIE infants and 7 controls using high-resolution manometry and graded pharyngeal stimulation.
  • Analyzed sensory-motor components of pharyngeal reflexive swallowing (PRS), upper esophageal sphincter (UES) function, and esophageal body characteristics.
  • Employed linear mixed and generalized estimating equation models for statistical comparisons.

Main Results:

  • HIE infants demonstrated fewer pharyngeal peaks and longer latency to terminal swallow compared to controls.
  • HIE infants at Time-1 showed increased UES resting tone and distal latency versus controls and Time-2.
  • Contractile vigor abnormalities increased with maturation in HIE infants relative to controls.

Conclusions:

  • HIE infants exhibit hypertonicity, impaired pharyngeal reflexes, and reduced smooth muscle contractile vigor, indicating poor propagation.
  • These deficits may lead to difficulties in clearing secretions, refluxate, and bolus material in the oropharynx.
  • Findings highlight potential mechanisms underlying feeding and swallowing impairments in HIE.
Abstract

Keywords:
asphyxiaesophageal motilitypremature infantswallowing

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