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Frequency-specific electrogastrography as a non-invasive tool to measure gastrointestinal maturity in preterm infants
Akhil Chaudhari1, Xinlong Wang1, Lindsay Roblyer2
1Department of Bioengineering, University of Texas at Arlington, Arlington, TX, USA.
Insights
Electrogastrography (EGG) shows gastrointestinal (GI) maturity in preterm infants. Gastric myoelectrical activity, measured by EGG, improves with advancing gestational age (GA), indicating potential for monitoring GI development.
Area of Science:
- Neonatology
- Gastroenterology
- Biomedical Engineering
Background:
- Enteral feeding in preterm infants is limited by immature gastrointestinal (GI) systems.
- Electrogastrography (EGG) offers a non-invasive method to assess gastric myoelectrical activity and GI maturation.
- Gastric rhythms (GR) include bradygastria, normogastria, and tachygastria, each with distinct frequency bands.
Purpose of the Study:
- To characterize EGG-derived parameters in preterm infants across different gestational ages (GA).
- To quantify power spectral density (PSD) and time spent in specific gastric rhythm bands.
- To assess the correlation between EGG findings and GI maturity in relation to GA.
Main Methods:
- Longitudinal study of 51 preterm infants monitored weekly via EGG from <29 weeks GA up to 40 weeks postmenstrual age.
- Analysis of EGG data included mean power spectral density (mPSD) within GR bands and percentage of time spent in each rhythm (bradygastria, normogastria, tachygastria).
- Continuous wavelet transform analysis was used to calculate rhythm percentages pre-, during, and post-feeding.
Main Results:
- EGG-measured mPSD in normogastria and tachygastria increased with advancing GA during feeding.
- % normogastria increased with advancing GA, irrespective of specific GR ranges.
- These findings suggest EGG can effectively measure GI maturity in preterm infants.
Conclusions:
- EGG parameters, specifically mPSD and % normogastria, demonstrate a clear correlation with advancing gestational age in preterm infants.
- EGG shows promise as a tool for objectively assessing gastrointestinal maturity and guiding enteral feeding strategies.
- Further research can validate EGG's role in optimizing nutritional support and clinical outcomes for preterm neonates.
Abstract:
Enteral feeding is challenging in preterm infants because of gastrointestinal (GI) immaturity. Electrogastrography (EGG) is a non-invasive technology that measures gastric myoelectrical activity and can be utilized to measure changes that occur with maturation at different gestational ages (GA). Three gastric rhythms (GR) exist between 0.5-9 cycles per minute (cpm), namely, bradygastria (0.5 ≤ GR < 2 cpm), normogastria (2 ≤ GR < 4 cpm), and tachygastria (4 ≤ GR < 9 cpm). We aimed to characterize EGG-derived parameters for different GA by quantifying (1) power spectral density (PSD) and its spectral means at three GR bands (i.e., mPSDGR) and (2) the percent (%) time spent in each band. Data analyzed was from a longitudinal cohort of preterm infants (n = 51) born at early, mid, and term GA of < 29, 29-33, and ≥ 37 weeks, respectively. Weekly EGG monitoring was performed until 40 weeks' postmenstrual age or discharge. Pre-, during, and post-feed data were analyzed for mPSDGR at each GR band. Also, % bradygastria, % normogastria, and % tachygastria were calculated by continuous wavelet transform analysis. Results showed (1) mPSD values in normogastria and tachygastria during feeding increased with advancing GA, and (2) % normogastria increased with advancing GA regardless of GR ranges, suggesting EGG may measure GI maturity in preterm infants.
