# Electrogastrography-Derived Mean Power Ratio as an Exploratory Objective Measure of Feeding Intolerance in Preterm Infants

## TL;DR

This study explores using electrogastrography to detect feeding intolerance in preterm infants by analyzing gastric activity during feeding.

## Contribution

The study introduces a novel exploratory use of electrogastrography-derived mean power ratios as a potential objective measure for feeding intolerance in preterm infants.

## Key findings

- Infants with feeding intolerance showed lower during-feeding power spectral density ratios in bradygastria and tachygastria bands.
- Baseline gastric activity was similar between infants with and without feeding intolerance.
- Electrogastrography detected reduced gastric activity during feeding in infants with feeding intolerance.

## Abstract

Feeding intolerance (FI) is common in preterm infants and disrupts enteral nutrition. Because clinical signs of FI are nonspecific, objective biomarkers are needed. In this exploratory study, we evaluated whether electrogastrography (EGG) can distinguish infants with FI from those with no FI (NFI) based on their gastric response to feeding. For each infant, the first available weekly EGG recording (postnatal week 1 or, if unavailable, week 2), comprising two consecutive feeding cycles, was analyzed. Each recording included pre-, during-, and post-feed segments. Power spectral density (PSD) was computed over 0.5–9 cycles per minute (cpm) to derive baseline mean PSD (mPSD) and PSD ratios (PSDR) for during/pre- and post/pre-feeding (PSDRDur/Pre, PSDRPost/Pre). Mean power ratios (mPR) were calculated across bradygastria, normogastria, and tachygastria frequency bands. Group differences were assessed using bootstrap resampling. Eighty-four infants were analyzed (75 NFI, 9 FI). Baseline mPSD values were comparable between the two groups. FI infants demonstrated lower PSDRDur/Pre values in the bradygastria and tachygastria bands, whereas normogastria responses were similar. No differences were observed in PSDRPost/Pre. EGG detected attenuated gastric activity specifically during feeding and not after feeding in infants with FI, supporting its potential as a non-invasive physiologic marker that warrants further validation.