Enteral feeding of intrauterine growth restriction preterm infants: theoretical risks and practical implications

Area of Science:

• Neonatalogy
• Perinatal Medicine
• Pediatric Gastroenterology

Background:

• Intrauterine growth restriction (IUGR) is linked to impaired gut function post-birth.
• This impairment stems from intrauterine blood flow redistribution caused by placental insufficiency, reducing gut perfusion.
• Consequently, infants with IUGR face an elevated risk of feeding intolerance.

Purpose of the Study:

• To investigate the utility of postnatal splanchnic evaluation in IUGR infants.
• To assess the persistence of intrauterine blood flow redistribution after birth.

Main Methods:

• Utilizing Doppler ultrasonography to evaluate superior mesenteric artery (SMA) blood flow.
• Employing near-infrared spectroscopy (NIRS) to measure splanchnic oxygenation.
• Correlating these postnatal findings with the intrauterine condition.

Main Results:

• Splanchnic perfusion and oxygenation measurements may indicate ongoing circulatory changes.
• These methods can help identify IUGR infants still experiencing reduced gut perfusion.
• Findings suggest a potential for early detection of persistent circulatory issues.

Conclusions:

• Postnatal evaluation of splanchnic perfusion and oxygenation is valuable in IUGR infants.
• These assessments can determine if intrauterine blood flow redistribution persists after birth.
• This approach may aid in managing feeding intolerance in this high-risk population.