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Gastric acid secretory function in preterm infants
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This study establishes normal gastric acid secretion values for preterm infants, showing acid output increases significantly in the first four weeks of life. These findings confirm a protective gastric pH barrier in most healthy preterm infants.
Area of Science:
- Neonatal Physiology
- Gastrointestinal Function
- Pediatric Gastroenterology
Background:
- Preterm infants often have immature gastrointestinal systems.
- Understanding gastric secretory function is crucial for infant health.
- Establishing normal values aids in assessing preterm infant development.
Purpose of the Study:
- To determine normal gastric acid output in healthy preterm infants.
- To track changes in gastric secretory function during early life.
- To correlate gastric pH with protective barriers against pathogens.
Main Methods:
- Longitudinal study of 34 healthy preterm infants.
- Weekly measurements of basal and pentagastrin-stimulated acid output.
- Assays for fasting serum gastrin and pancreatic polypeptide levels.
Main Results:
- Basal acid output increased from 12 to 30 mumol/kg/hr in the first 4 weeks.
- Pentagastrin-stimulated acid output rose from 21 to 44 mumol/kg/hr in the first 4 weeks.
- Gastric acid secretion stabilized after 4 weeks; serum gastrin doubled by 2 months.
Conclusions:
- Healthy preterm infants achieve sufficient acid secretion for gastric pH control.
- Gastric acid provides a barrier against bacterial and protein antigen colonization.
- Established normal values serve as a benchmark for preterm infant gastric function.
Abstract:
To establish normal values for gastric secretory function in preterm infants, we studied 34 healthy preterm infants once a week during hospitalization. Basal acid output, pentagastrin-stimulated acid output, fasting serum gastrin, and fasting serum pancreatic polypeptide were measured during each study. Basal acid output at 1 week of age was 12 mumol/kg/hr, increasing over the first 4 weeks to 30 mumol/kg/hr. Administration of pentagastrin 6 micrograms/kg subcutaneously increased acid output in all age groups. Pentagastrin-stimulated acid output at 1 week was 21 mumol/kg/hr, increasing over the first 4 weeks to 44 mumol/kg/hr. Acid secretion did not change significantly over the next 4 to 6 weeks. Fasting serum gastrin concentration was stable over the first 6 weeks of life, but doubled during the end of the second month. Pancreatic polypeptide was found at low levels throughout the study. These studies confirm that the majority of healthy preterm infants secrete acid in quantity sufficient to maintain the gastric pH less than or equal to 4, providing a barrier to bacteria and protein antigens.