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Radiographic Imaging to Evaluate Food Passage Rate in Preterm Piglets as a Model for Preterm Infants
Susanne Soendergaard Kappel1,2, Per Torp Sangild1,2,3, Thomas Scheike4
1Comparative Pediatrics and Nutrition, University of Copenhagen, Copenhagen, Denmark.
Insights
Preterm piglets show faster gut passage rates than near-term ones, influenced by age and diet. This study highlights the preterm piglet as a model for infant gut motility research.
Area of Science:
- Gastroenterology
- Neonatal Physiology
- Comparative Medicine
Background:
- Gut motility in infants matures with age and is influenced by various factors.
- Understanding how age and diet affect gut motility in preterm neonates is crucial for managing feeding intolerance and gastric residuals.
Purpose of the Study:
- To investigate the influence of gestational age, postnatal age, and milk diet on gut motility in preterm piglets using X-ray contrast imaging.
- To assess the suitability of preterm piglets as a model for studying factors affecting gut motility in preterm infants.
Main Methods:
- Serial abdominal X-ray imaging was used to evaluate contrast passage rate in preterm and near-term piglets.
- Piglets were fed infant formula, colostrum, or intact bovine milk, with or without fortifier, on postnatal days 4 and 18 (n=140).
Main Results:
- Preterm piglets exhibited faster small intestinal passage rates at day 4 compared to near-term piglets.
- Formula-fed piglets showed faster passage to the cecum and through the colon than colostrum-fed piglets at day 4.
- Younger preterm piglets (day 4) had slower gastric emptying and colonic passage than older piglets (day 18).
- Nutrient fortification increased growth and residuals but did not alter passage rates.
Conclusions:
- X-ray contrast imaging is a viable method for assessing food passage rate in preterm piglets.
- Gut contrast passage rate is significantly affected by gestational age, postnatal age, and milk diet.
- The preterm piglet model effectively simulates preterm infant gut physiology, aiding research into feeding tolerance and gut health.
Abstract:
Objectives and study: Gut motility in infants mature with increasing post-menstrual age and is affected by numerous hormonal, immunological and nutritional factors. However, it remains unclear how age and diet influence gut motility and its relation to feeding intolerance and gastric residuals in preterm neonates. Using preterm piglets as a model for infants, we investigated if contrast passage rate, as determined by X-ray contrast imaging, is affected by gestational age at birth, advancing postnatal age and different milk diets. Methods: Contrast passage rate was evaluated using serial abdominal X-ray imaging on postnatal day 4 and 18 in preterm and near-term piglets fed infant formula, colostrum or intact bovine milk, with or without added fortifier (total n = 140). Results: Preterm piglets had a faster small intestinal passage rate of contrast solution at day 4 of life than near-term piglets (SIEmpty, hazard ratio (HR): 0.52, 95%CI [0.15, 0.88], p < 0.01). Formula fed piglets at day 4 had a faster passage rate of contrast to caecum (ToCecum, HR: 0.61, 95%CI [0.25,0.96], p = 0.03), and through the colon region (CaecumToRectum, p < 0.05, day 4) than colostrum fed preterm piglets. The time for contrast to leave the stomach, and passage through the colon in day 4 preterm piglets were slower than in older piglets at day 18 (both, p < 0.05). Adding a nutrient fortifier increased body growth, gastric residuals, intestinal length and weight, but did not affect any of the observed passage rates of the contrast solution. Conclusion: Serial X-ray contrast imaging is a feasible method to assess food passage rate in preterm piglets. Contrast passage rate through different gut segments is affected by gestational age at birth, postnatal age, and milk diet. The preterm piglet could be a good model to investigate clinical and dietary factors that support maturation of gut motility and thereby feeding tolerance and gut health in preterm infants.
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