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. 2022 Nov 1;75(5):564-571.
doi: 10.1097/MPG.0000000000003575. Epub 2022 Aug 18.

Tachygastria in Preterm Infants: A Longitudinal Cohort Study

Eric Brum Ortigoza  1 , Jackson Cagle  2 , Larry Steven Brown  3 , Sherief Mansi  4 , Sandra Peralez Gosser  3 , Ashley D Montgomery  3 , Zeri Foresman  3 , Monica L Boren  3 , Pamela S Pettit  3 , Tami D Thompson  3 , Diana M Vasil  1 , Jui-Hong Chien  5 , Josef Neu  6 , Andrew Young Koh  7   8   9 , Rinarani Sanghavi  4 , Julie Mirpuri  1
Affiliations

Tachygastria in Preterm Infants: A Longitudinal Cohort Study

Eric Brum Ortigoza et al. J Pediatr Gastroenterol Nutr. .

Abstract

Objectives: Tachygastria is a gastric dysrhythmia (>4 to ≤9 cycles per minute, cpm) associated with gastric hypomotility and gastrointestinal disorders. Healthy preterm infants spend more time in tachygastria than adults; however, normative values are not defined. We sought to determine the percent of time preterm infants spend in tachygastria.

Methods: We conducted a longitudinal, prospective cohort study with weekly electrogastrography (EGG) recordings in 51 preterm <34 weeks' gestation and 5 term (reference) infants. We calculated percentage recording time in tachygastria (% tachygastria) and determined the mean ± standard deviation (SD) across EGG sessions. Mixed effects model was performed to test weekly variance in % tachygastria and gestational age effect. Successive pre- and post-prandial measurements were obtained to assess reproducibility of % tachygastria. We compared time to achieve full feeds between subjects with % tachygastria within 1 SD from the mean versus % tachygastria >1 SD from mean.

Results: Three hundred seventy-six EGG sessions were completed (N = 56). Mean % tachygastria was 40% with SD ±5%. We demonstrated no change in % tachygastria across 9 postnatal weeks (P = 0.70) and no gestational age effect. No difference was demonstrated between successive pre- (P = 0.91) and post-prandial (P = 0.96) % tachygastria. Infants with 35%-45% tachygastria (within 1 SD from mean) had higher gestational age and less time to achieve full feeds than infants with <35% or >45% tachygastria.

Conclusions: EGG is a reproducible tool to assess % tachygastria in preterm infants. Clinical significance of increased or decreased % tachygastria needs further investigation to validate if 35%-45% tachygastria is safe for feeding.

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Conflict of interest statement

E.B.O., J.-H.C., and J.N. share Patent #US10478116 B2 (University of Florida Research Foundation, Inc.), there are no competing financial interests. J.N. receives research support from Infant Bacterial Therapeutics and is a consultant for Astarte. R.S. is a consultant for Allergan and is a member on the Speaker’s Bureau for Abbott Nutrition. The remaining authors report no conflicts of interest.

Figures

Figure 1.
Figure 1.
Timeline of Electrogastrography Recording.
Figure 2.
Figure 2.. Percent Recording Time in Tachygastria.
a) Percent recording time in tachygastria was 35–45% (1SD from the mean). The first 10 weekly pre-prandial EGG sessions are shown for each subject. Data were arranged and displayed by gestational age groups. b) Boxplot showing distribution of % tachygastria for all EGG sessions of the cohort. c) Repeated measures analysis (linear mixed effects model with random subject effect) for preterm infants (n=51) demonstrated consistency of the pre-prandial % tachygastria measure between weeks 1–9 (p=0.70) with a decrease in week 10 (p=0.009) and 13 (p=0.015). SD = standard deviation, cpm = cycles per minute.
See this image and copyright information in PMC

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