Abstract 655

As mortality has decreased among premature infants, morbidity related to feeding problems has increased dramatically. Functional maturation lags behind structural development from birth through two years of life.

Aim: To investigate the characteristics of gastromyoelectric activity we have performed 185 surface electrogastrographic studies in 32 neonates.

Method: Following parental and institutional consent serial recordings of gastromyoelectric activity were obtained in 32 premature infants whose gestational age ranged from 23 - 34 weeks. All electrodes were positioned by the above authors and then connected to a digitrapper, which digitalized the data. Data was then analyzed utilizing a special program designed by Synetics Medical.

Results: From birth through four months of extrauterine life premature infants regardless of gestational age have a gastromyoelectric activity pattern dramatically different from that reported in children and adults. Normogastric wave forms (2.4 to 3.7 cycles per minute) - those associated with normal gastric contractions - are the predominant waves observed in all patients at all ages studied. Of note was the observation in our population of a markedly diminished frequency of this particular waveform (normogastria) which was less than sixty percent of that observed in the more mature patient. Minor differences were observed in two infants with imperforated anus and two with NEC.

Conclusions:

1. EGG patterns suggest a developmental delay in normal wave patterns which may effect gut motility.

2. Patients displayed a fairly stable EGG frequency distribution pattern that was constant over time. Changes in this distribution, detected by our sequential measurements, were often accompanied by clinical events such as sepsis or medical NEC.

3. Infants with imperforate anus (obstruction) had a greater frequency of tachygastria before and after surgery.

4. The usefulness of this method for the evaluation of feeding intolerance in children, for more precise identification of the factors contributing to gastro-esophageal reflux and other aspects of the dysmotility often appreciated in the premature infant remains a future area of study. A potential area of application could be the early warning of intestinal ischemia that can precede the development of necrotizing enterocolitis.