354 Surface Electrogastrography in Growing Preterm Neonates

Abstract

Background: The ability to provide enteral nutrition to preterm infants is limited by immaturity of GI motor function. Manometry and electrogastrography(EGG) have been used to study gastric dysrhythmias and GI motor disorders in adults. EGG has been shown to be a reliable non-invasive alternative technique to gastric manometry in preterm infants. The information on pattern and maturation of EGG is limited in preterm infants. Objective: To investigate the effect of gestational and postnatal age on the pattern of gastric myoelectrical activity in preterm infants without feeding intolerance and those with gastroesophageal reflux(GER). Methods: EGG signals were recorded at 10Hz and bandpass filtered between 1.2 and 18 cycles/min(cpm), 30 minutes before and 2 hours after feeds. Signals were analyzed by FFT spectral analysis. The percentage of regular 2–4 cpm normal slow wave activity (NSW) and tachygastria(4–10cpm)was determined from a running power spectrum analysis generated at 10 minute intervals. Results: 70 EGGs were obtained in 31 infants; BW 1550±758SD g, range 618 to 3494, GA 30.7±4.5 SD wks, range 25 to 40, study age 38±24SD days, range 2–112. Preterm infants at term PCA had lower pre feeds NSW than those born at term(30.1±5.9% vs 41.7±14.8%). After feeds NSW increased in both groups ( 37.9±3.8% vs 52.1±10.8%). GER babies had 35% lower NSW than controls before feeds. NSW increased 53% after feeds in GER babies vs 13% in controls. tachygastria activity was 1.4 vs 7.8% (p=0.03) pre feeds, and 6.1 vs 6.8% post feeds in GER group as compared to controls. Conclusions: Preterm infants have less normal slow wave activity as compared to term infants which persisted up to term PCA. The response to feeds was less but similar to babies born at term. Maturation of Gastric myoelectrical activity of preterm infants with GER appears to lag behind that of infants without feeding intolerance.