Susanne Soendergaard Kappel1,2, Per Torp Sangild1,2,3, Thomas Scheike4, Christel Renée Friborg2, Magdalena Gormsen5, Lise Aunsholt1,2. 1. Comparative Pediatrics and Nutrition, University of Copenhagen, Copenhagen, Denmark. 2. Department of Neonatology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark. 3. Department of Pediatrics, Odense University Hospital, Odense, Denmark. 4. Section of Biostatistics, Department of Public Health, University of Copenhagen, Copenhagen, Denmark. 5. Department of Radiology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.
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.
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.
Authors: René L Shen; Thomas Thymann; Mette V Østergaard; Ann Cathrine F Støy; Łukasz Krych; Dennis S Nielsen; Charlotte Lauridsen; Bolette Hartmann; Jens J Holst; Douglas G Burrin; Per T Sangild Journal: Am J Physiol Gastrointest Liver Physiol Date: 2015-07-02 Impact factor: 4.052
Authors: Wenchao Chen; Jing Sun; Susanne S Kappel; Magdalena Gormsen; Per T Sangild; Lise Aunsholt Journal: Pediatr Res Date: 2020-04-04 Impact factor: 3.756
Authors: Stine O Rasmussen; Lena Martin; Mette V Østergaard; Silvia Rudloff; Yanqi Li; Michael Roggenbuck; Stine B Bering; Per T Sangild Journal: Am J Physiol Gastrointest Liver Physiol Date: 2016-07-21 Impact factor: 4.052