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Parietal cell function of full-term and premature infants: unstimulated gastric acid and intrinsic factor secretion
Insights
Premature infants can secrete intrinsic factor (IF) similarly to full-term infants, though their acid secretion is lower. Intrinsic factor is present at birth, suggesting in utero production.
Area of Science:
- Neonatal Physiology
- Gastroenterology
- Endocrinology
Background:
- Gastric acid and intrinsic factor (IF) are crucial for nutrient absorption in infants.
- Understanding the secretory capacity of the premature infant's gastric system is vital for neonatal care.
Purpose of the Study:
- To compare gastric acid and intrinsic factor (IF) secretion in premature and full-term infants.
- To investigate the presence and potential origin of intrinsic factor (IF) at birth.
Main Methods:
- Collected basal gastric secretions for 1 hour from healthy full-term and premature infants.
- Measured gastric juice volume, acid secretion, and intrinsic factor (IF) secretion.
- Assessed IF detectability in gastric secretions immediately after birth in a separate cohort.
Main Results:
- Gastric juice volume and IF secretion were comparable between premature and full-term infants.
- Acid secretion was significantly lower in premature infants compared to full-term infants (p < 0.01).
- A positive linear correlation between acid and IF secretion was observed in full-term infants, but not in premature infants.
Conclusions:
- Premature infants' parietal cells possess a similar capacity for IF secretion as those of mature infants.
- The presence of IF in gastric secretions at birth suggests in utero secretion, independent of enteral feeding stimulation.
Abstract:
A 1-h basal collection of gastric secretions was taken from 14 healthy full-term infants (group I) and 10 premature infants (group II). Simultaneously, acid and intrinsic factor (IF) secretion was measured. In an additional group of 19 full-term infants (group III), 16 had IF detectable in their gastric secretions immediately at birth. Volumes of gastric juice (ml/kg/h) and IF secretion (ng/kg/h) were similar for group I and group II infants. Acid secretion (mEq/kg/h) was significantly less in group II (p less than 0.01). There was a linear correlation between acid secretion (mEq/kg/h) and IF secretion (ng/kg/h) for group I (r = 0.85, p less than 0.001). There was no correlation between the values for the premature infants in group II. The study documents that the parietal cell of the premature infant has the same capacity to secrete IF as the cell of the more mature infant. It also demonstrates the presence at birth of IF in gastric secretions, which suggests in utero secretion and independence from enteral feeding for stimulation.