487 - Electrogastrography as a Non-Invasive Tool to Measure Gastrointestinal Maturity in Preterm Infants

Poster Number: 487
Publication Number: 487.424

Eric B. Ortigoza, UT Southwestern Medical Center, Dallas, TX, United States; Akhil V. Chaudhari, University of texas at Arlington, Arlington, TX, United States; Lindsay Roblyer, University of Texas Southwestern Medical School, Dallas, TX, United States; Rinarani M. Sanghavi, University of Texas Southwestern Medical School, Dallas, TX, United States; Xinlong Wang, University of Texas at Arlington, Arlington, TX, United States; Hanli Liu, University of Texas at Arlington, Arlington, TX, United States

Background: Enteral feeding can be challenging in preterm infants because of gastrointestinal (GI) immaturity leading to feeding intolerance. Current techniques to monitor feeding intolerance are non-specific and poor predictors of GI maturity and feeding readiness. Objective measures of GI maturity are needed for more accurate assessment of feeding readiness. Electrogastrography (EGG) is a non-invasive technology that can be utilized to measure gastric myoelectrical activity in infants of different gestational ages (GA).

Objective: To characterize differences in EGG parameters of gastric myoelectrical activity (mean power spectral density or PSD and % time in normogastria) in infants of different GA before, during, and after feeding.

Design/Methods: We conducted a longitudinal cohort study of infants born < 34 and ≥37 weeks GA. Subjects underwent weekly EGG monitoring until 40 weeks postmenstrual age (PMA) or discharge, if earlier. Pre-prandial, prandial, and post-prandial EGG measurements were obtained. Using Matlab, mean PSD at 3 frequency bands ( < 2, 2-4, 4-9 cycles per minute or cpm) and % time in normogastria (at 2-4 cpm) were calculated from the raw EGG data. Subjects were stratified into 3 GA groups (early < 29, mid 29-33, and term ≥37 weeks). One-way ANOVA and two-sample t-test were used for group comparisons. Linear regression was used to assess the relationship between % time in normogastria vs. PMA.

Results: 51 infants were included in the study. Mean PSD in mV2/Hz (at 4-9 cpm) was significantly lower for infants < 29 than 29-33 weeks (pre-prandial: 0.26 vs. 0.15, p=0.012; prandial: 0.21 vs. 0.11, p=0.005; post-prandial: 0.22 vs. 0.13, p=0.006); see Fig. 1. In preterm infants < 29 and 29-33 weeks, the mean PSD did not change with feeding (Fig. 2); however, term infants demonstrated an increase in mean PSD during feeds. Also, % time in normogastria (2-4 cpm) increased significantly with increasing GA (pre-prandial: r2=0.14, p< 0.01; prandial: r2=0.25, p< 0.01; post-prandial: r2=0.18, p< 0.01); see Fig. 3.Conclusion(s): EGG-derived mean PSD in preterm infants increases with GA, suggesting maturation of the myoelectrical signal. Enteral feeding did not change the mean PSD in preterm infants, suggesting an immature myoelectrical response to feeding compared to term infants. The %  time in normal gastric rhythm (normogastria) increases with PMA, suggesting a decrease in gastric dysrhythmias with maturation. Measurement of gastric myoelectrical activity by EGG may help assess GI maturity in preterm infants. Evaluation of EGG as a tool to predict feeding readiness needs to be explored further.
Enteral Feeding Does Not Influence the Mean Power Spectral Density (PSD) in Preterm Infants
<img src=https://www.abstractscorecard.com/uploads/Tasks/upload/16020/FGOVBGGC-1178934-2-IMG.jpg width=440 hheight=159.707495429616 border=0 style=border-style: none;>Enteral feeding did not change the mean PSD in preterm infants (GA < 29 and 29-33 weeks), suggesting a more immature myoelectrical response to feeding compared to term infants.
Early ( < 29 weeks' gestation), Mid (29-33 weeks' gestation), Term (>=37 weeks' gestation), gestational age (GA), millivolts (mV), Hertz (Hz). Asterix indicates statistical significance (p < 0.05).