A longitudinal study of electrogastrography in normal neonates

Background/Porpose: Gastric motility is partly regulated by an inherent ele ctric control activity (ECA), Electrogastrography (EGG) measures gastric EC A through cutaneous electrodes, Little is known about EGG in neonates, A sl ow wave frequency of 3 cycles per minute (cpm) accounts for 85% to 100% of gastric ECA in normal adults and children. However, the authors have shown previously a lower percentage of 3 cpm activity in neonates, Abnormal EGG p atterns (tachygastria and bradygastria) have been described in adults and c hildren with gastric motility disorders. In neonates, especially premature infants, disorders of gastrointestinal motility are common, especially afte r gastrointestinal operations. It is necessary to characterise normal ECA b efore the pathophysiology of these disorders can be studied. The aim of thi s study was to investigate the pattern of ECA in the developing neonate. Methods: Nine healthy neonates born at 34 weeks' gestation were studied usi ng Synectics EGG sampling at 4Hz, Each subject underwent 4 hourly EGG recor dings at fortnightly intervals from birth until age 8 weeks, and then every 2 months until age 2 years. The paired sample t test (95% Confidence Inter val [CI]) was used to compare recordings. Results: Between birth and age 2 years, 3 cpm activity increased from 38% t o 57% of recorded rime. The mean percentage recorded time of tachygastria d ecreased from 47% to 35%, and bradygastria decreased from 15% to 8%. Statis tically significant differences were seen between birth, 6 months, and 2 ye ars of age. Conclusions: The pattern of ECA in the normal neonatal stomach differs from that seen in adult studies. Tachygastria and bradygastria are seen more fr equently, with fewer periods of 3 cpm. There is an increase in the percenta ge of 3 cpm activity over time, with statistically significant differences from the ECA pattern at birth first seen at the age of 6 months. The author s suggest that neonatal ECA undergoes a maturation process and that larger longitudinal and normal range studies are required to investigate this phen omenon. Copyright (C) 2000 by W.B. Saunders Company.