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Gewolb IH, Sobowale BT, Vice FL, Patwardhan A, Solomonia N, Reynolds EW. The Effect of Severe Intraventricular Hemorrhage on the Biorhythms of Feeding in Premature Infants. Front Pediatr 2021; 9:673152. [PMID: 34497781 PMCID: PMC8419420 DOI: 10.3389/fped.2021.673152] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 07/29/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Suck-swallow rhythmicity and the integration of breathing into infant feeding are developmentally regulated. Neurological injury and breathing abnormalities can both impact feeding in preterm infants. Objective: To determine the effects of neurologic injury independent of effects of disordered breathing on feeding biorhythms in premature infants. Methods: Low-risk preterm infants (LRP), infants with Grade 3-4 Intraventricular Hemorrhage (IVH), those with bronchopulmonary dysplasia (BPD), and those with both BPD and IVH (BPD+IVH) were identified. Forty-seven infants, 32-42 weeks Postmenstrual Age (PMA) were evaluated on one or more occasions (131 studies). Of these, 39 infants (81 studies) were performed at >35 weeks PMA. Coefficient of variation (COV) (=standard deviation of the inter-event (e.g., suck-suck, swallow-breath, etc.) interval divided by the mean of the interval) was used to quantify rhythmic stability. Results: To adjust for PMA, only those infants >35-42 weeks were compared. Suck-suck COV was significantly lower (more rhythmically stable) in the LRP group [COV = 0.274 ± 0.051 (S.D.)] compared to all other groups (BPD = 0.325 ± 0.066; IVH = 0.342 ± 0.072; BPD + IVH = 0.314 ± 0.069; all p < 0.05). Similarly, suck-swallow COV was significantly lower in LRP babies (0.360 ± 0.066) compared to the BPD group (0.475 ± 0.113) and the IVH cohort (0.428 ± 0.075) (p < 0.05). The BPD+IVH group (0.424 ± 0.109), while higher, was not quite statistically significant. Conclusions: Severe IVH negatively impacts suck-suck and suck-swallow rhythms. The independent effect of neurological injury in the form of IVH on feeding rhythms suggests that quantitative analysis of feeding may reflect and predict neurological sequelae.
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Affiliation(s)
- Ira H Gewolb
- Division of Neonatology, Department of Pediatrics and Human Development, Michigan State University, East Lansing, MI, United States
| | - Babatunde T Sobowale
- Division of Neonatology, Department of Pediatrics and Human Development, Michigan State University, East Lansing, MI, United States
| | - Frank L Vice
- Division of Neonatology, Department of Pediatrics and Human Development, Michigan State University, East Lansing, MI, United States
| | - Abhijit Patwardhan
- Department of Biomedical Engineering, University of Kentucky, Lexington, KY, United States
| | - Nino Solomonia
- Division of Neonatology, Department of Pediatrics, University of Kentucky School of Medicine, Lexington, KY, United States.,M. Iashvili Childrens Central Hospital, Tbilisi, Georgia
| | - Eric W Reynolds
- Division of Neonatology, Department of Pediatrics, University of Kentucky School of Medicine, Lexington, KY, United States.,McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, United States
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