Very preterm infants show 21.0% intestinal blood flow rise after first feeding vs 93.5% in term infants
A Doppler study of 100 infants found a weaker rise in superior mesenteric artery flow after feeding in very preterm babies, and the lowest values in those with feeding intolerance.
A prospective cohort study reported on doi.org measured how intestinal blood flow changes after the first feeding in 100 newborns. The postprandial splanchnic hyperemia (PSH), the increase in intestinal blood flow after feeding, was lower in very preterm infants than in older groups, the authors reported nature.com
doi.orgnature.comOpen source ↗. The study included 60 very preterm infants (gestational age of 32 weeks or less), 20 moderate or late preterm infants (over 32 and under 37 weeks) and 20 term infants (37 weeks or more).
Method and measurements
The researchers used Doppler ultrasound to measure blood flow rate in the superior mesenteric artery. Measurements were taken before and 30 minutes after the first feeding. PSH was calculated as the percentage increase in the post-feeding flow rate, and the team then examined its links with gestational age and feeding intolerance.
PSH was 21.0% in very preterm infants, 65.7% in moderate or late preterm infants and 93.5% in term infants (P < 0.001). After adjustment for the initial feeding volume, gestational age was not independently associated with PSH (P = 0.07).
Feeding intolerance
Twenty-two infants developed feeding intolerance nature.com
doi.orgnature.comOpen source ↗. Among very preterm infants, those with feeding intolerance had a PSH of −10.4%, compared with 34.4% in those without feeding complications (P = 0.004). According to the authors, impaired PSH at the first feeding independently predicts feeding intolerance in preterm infants.
The authors state that the results help reconcile earlier conflicting data. In their interpretation, flow velocity may not change with gestational age, while the actual flow volume and the PSH capacity are underdeveloped in preterm infants. They also propose using PSH at the first feeding as a predictive marker for early risk stratification and for personalized feeding regimens, which might reduce the risk of necrotizing enterocolitis.
The datasets are not publicly available because of patient confidentiality and institutional data protection rules. De-identified Doppler imaging data can be requested from the corresponding author, subject to institutional approval.
