Provision of amniotic fluid during parenteral nutrition increases weight gain with limited effects on gut structure, function, immunity, and microbiology in newborn preterm pigs

Mette Viberg Østergaard; Rene Liang Shen; Ann Cathrine Findal Støy; Kerstin Skovgaard; Łukasz Krych; Stine Sofie Leth; Dennis Sandris Nielsen; Bolette Hartmann; Stine Brandt Bering; Mette Schmidt; Per Torp Sangild

doi:10.1177/0148607114566463

Provision of amniotic fluid during parenteral nutrition increases weight gain with limited effects on gut structure, function, immunity, and microbiology in newborn preterm pigs

Mette Viberg Østergaard, Rene Liang Shen, Ann Cathrine Findal Støy, Kerstin Skovgaard, Łukasz Krych, Stine Sofie Leth, Dennis Sandris Nielsen, Bolette Hartmann, Stine Brandt Bering, Mette Schmidt, Per Torp Sangild

17 Citations (Scopus)

Abstract

Background: Small enteral boluses with human milk may reduce the risk of subsequent feeding intolerance and necrotizing enterocolitis in preterm infants receiving parenteral nutrition (PN). We hypothesized that feeding amniotic fluid, the natural enteral diet of the mammalian fetus, will have similar effects and improve growth and gastrointestinal (GI) maturation in preterm neonates receiving PN, prior to the transition to milk feeding. Materials and Methods: Twenty-seven pigs, delivered by cesarean section at ~90% of gestation, were provided with PN and also fed boluses with amniotic fluid (AF; n = 13, 24-72 mL/kg/d) or no oral supplements (nil per os [NPO]; n = 14) until day 5 when blood, tissue, and fecal samples were collected for analyses. Results: Body weight gain was 2.7-fold higher in AF vs NPO pigs. AF pigs showed slower gastric emptying, reduced meal-induced release of gastric inhibitory peptide and glucagon-like peptide 2, changed gut microbiota, and reduced intestinal permeability. There were no effects on GI weight, percentage mucosa, villus height, plasma citrulline, hexose absorptive capacity, and digestive enzymes. Intestinal interleukin (IL)-1β levels and expression of IL1B and IL8 were increased in AF pigs, while blood biochemistry and amino acid levels were minimally affected. Conclusion: Enteral boluses of AF were well tolerated in the first 5 days of life in preterm pigs receiving PN. Enteral provision of AF before the initiation of milk feeding may stimulate body growth and improve hydration in preterm infants receiving PN. Furthermore, it may improve GI motility and integrity, although most markers of GI maturation remain unchanged.

Original language	English
Journal	Journal of Parenteral and Enteral Nutrition
Volume	40
Issue number	4
Pages (from-to)	552-566
Number of pages	15
ISSN	0148-6071
DOIs	https://doi.org/10.1177/0148607114566463
Publication status	Published - May 2014

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Østergaard, M. V., Shen, R. L., Støy, A. C. F., Skovgaard, K., Krych, Ł., Leth, S. S., Nielsen, D. S., Hartmann, B., Bering, S. B., Schmidt, M., & Sangild, P. T. (2014). Provision of amniotic fluid during parenteral nutrition increases weight gain with limited effects on gut structure, function, immunity, and microbiology in newborn preterm pigs. Journal of Parenteral and Enteral Nutrition, 40(4), 552-566. https://doi.org/10.1177/0148607114566463

Provision of amniotic fluid during parenteral nutrition increases weight gain with limited effects on gut structure, function, immunity, and microbiology in newborn preterm pigs. / Østergaard, Mette Viberg; Shen, Rene Liang; Støy, Ann Cathrine Findal et al.
In: Journal of Parenteral and Enteral Nutrition, Vol. 40, No. 4, 05.2014, p. 552-566.

Research output: Contribution to journal › Journal article › Research › peer-review

Østergaard, MV, Shen, RL, Støy, ACF, Skovgaard, K, Krych, Ł, Leth, SS, Nielsen, DS , Hartmann, B , Bering, SB, Schmidt, M & Sangild, PT 2014, 'Provision of amniotic fluid during parenteral nutrition increases weight gain with limited effects on gut structure, function, immunity, and microbiology in newborn preterm pigs', Journal of Parenteral and Enteral Nutrition, vol. 40, no. 4, pp. 552-566. https://doi.org/10.1177/0148607114566463

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title = "Provision of amniotic fluid during parenteral nutrition increases weight gain with limited effects on gut structure, function, immunity, and microbiology in newborn preterm pigs",

abstract = "Background: Small enteral boluses with human milk may reduce the risk of subsequent feeding intolerance and necrotizing enterocolitis in preterm infants receiving parenteral nutrition (PN). We hypothesized that feeding amniotic fluid, the natural enteral diet of the mammalian fetus, will have similar effects and improve growth and gastrointestinal (GI) maturation in preterm neonates receiving PN, prior to the transition to milk feeding. Materials and Methods: Twenty-seven pigs, delivered by cesarean section at ~90% of gestation, were provided with PN and also fed boluses with amniotic fluid (AF; n = 13, 24-72 mL/kg/d) or no oral supplements (nil per os [NPO]; n = 14) until day 5 when blood, tissue, and fecal samples were collected for analyses. Results: Body weight gain was 2.7-fold higher in AF vs NPO pigs. AF pigs showed slower gastric emptying, reduced meal-induced release of gastric inhibitory peptide and glucagon-like peptide 2, changed gut microbiota, and reduced intestinal permeability. There were no effects on GI weight, percentage mucosa, villus height, plasma citrulline, hexose absorptive capacity, and digestive enzymes. Intestinal interleukin (IL)-1β levels and expression of IL1B and IL8 were increased in AF pigs, while blood biochemistry and amino acid levels were minimally affected. Conclusion: Enteral boluses of AF were well tolerated in the first 5 days of life in preterm pigs receiving PN. Enteral provision of AF before the initiation of milk feeding may stimulate body growth and improve hydration in preterm infants receiving PN. Furthermore, it may improve GI motility and integrity, although most markers of GI maturation remain unchanged.",

author = "{\O}stergaard, {Mette Viberg} and Shen, {Rene Liang} and St{\o}y, {Ann Cathrine Findal} and Kerstin Skovgaard and {\L}ukasz Krych and Leth, {Stine Sofie} and Nielsen, {Dennis Sandris} and Bolette Hartmann and Bering, {Stine Brandt} and Mette Schmidt and Sangild, {Per Torp}",

note = "CURIS 2016 NEXS 113",

year = "2014",

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doi = "10.1177/0148607114566463",

language = "English",

volume = "40",

pages = "552--566",

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T1 - Provision of amniotic fluid during parenteral nutrition increases weight gain with limited effects on gut structure, function, immunity, and microbiology in newborn preterm pigs

AU - Østergaard, Mette Viberg

AU - Shen, Rene Liang

AU - Støy, Ann Cathrine Findal

AU - Skovgaard, Kerstin

AU - Krych, Łukasz

AU - Leth, Stine Sofie

AU - Nielsen, Dennis Sandris

AU - Hartmann, Bolette

AU - Bering, Stine Brandt

AU - Schmidt, Mette

AU - Sangild, Per Torp

N1 - CURIS 2016 NEXS 113

PY - 2014/5

Y1 - 2014/5

N2 - Background: Small enteral boluses with human milk may reduce the risk of subsequent feeding intolerance and necrotizing enterocolitis in preterm infants receiving parenteral nutrition (PN). We hypothesized that feeding amniotic fluid, the natural enteral diet of the mammalian fetus, will have similar effects and improve growth and gastrointestinal (GI) maturation in preterm neonates receiving PN, prior to the transition to milk feeding. Materials and Methods: Twenty-seven pigs, delivered by cesarean section at ~90% of gestation, were provided with PN and also fed boluses with amniotic fluid (AF; n = 13, 24-72 mL/kg/d) or no oral supplements (nil per os [NPO]; n = 14) until day 5 when blood, tissue, and fecal samples were collected for analyses. Results: Body weight gain was 2.7-fold higher in AF vs NPO pigs. AF pigs showed slower gastric emptying, reduced meal-induced release of gastric inhibitory peptide and glucagon-like peptide 2, changed gut microbiota, and reduced intestinal permeability. There were no effects on GI weight, percentage mucosa, villus height, plasma citrulline, hexose absorptive capacity, and digestive enzymes. Intestinal interleukin (IL)-1β levels and expression of IL1B and IL8 were increased in AF pigs, while blood biochemistry and amino acid levels were minimally affected. Conclusion: Enteral boluses of AF were well tolerated in the first 5 days of life in preterm pigs receiving PN. Enteral provision of AF before the initiation of milk feeding may stimulate body growth and improve hydration in preterm infants receiving PN. Furthermore, it may improve GI motility and integrity, although most markers of GI maturation remain unchanged.

AB - Background: Small enteral boluses with human milk may reduce the risk of subsequent feeding intolerance and necrotizing enterocolitis in preterm infants receiving parenteral nutrition (PN). We hypothesized that feeding amniotic fluid, the natural enteral diet of the mammalian fetus, will have similar effects and improve growth and gastrointestinal (GI) maturation in preterm neonates receiving PN, prior to the transition to milk feeding. Materials and Methods: Twenty-seven pigs, delivered by cesarean section at ~90% of gestation, were provided with PN and also fed boluses with amniotic fluid (AF; n = 13, 24-72 mL/kg/d) or no oral supplements (nil per os [NPO]; n = 14) until day 5 when blood, tissue, and fecal samples were collected for analyses. Results: Body weight gain was 2.7-fold higher in AF vs NPO pigs. AF pigs showed slower gastric emptying, reduced meal-induced release of gastric inhibitory peptide and glucagon-like peptide 2, changed gut microbiota, and reduced intestinal permeability. There were no effects on GI weight, percentage mucosa, villus height, plasma citrulline, hexose absorptive capacity, and digestive enzymes. Intestinal interleukin (IL)-1β levels and expression of IL1B and IL8 were increased in AF pigs, while blood biochemistry and amino acid levels were minimally affected. Conclusion: Enteral boluses of AF were well tolerated in the first 5 days of life in preterm pigs receiving PN. Enteral provision of AF before the initiation of milk feeding may stimulate body growth and improve hydration in preterm infants receiving PN. Furthermore, it may improve GI motility and integrity, although most markers of GI maturation remain unchanged.

U2 - 10.1177/0148607114566463

DO - 10.1177/0148607114566463

M3 - Journal article

C2 - 25613990

SN - 0148-6071

VL - 40

SP - 552

EP - 566

JO - Journal of Parenteral and Enteral Nutrition

JF - Journal of Parenteral and Enteral Nutrition

IS - 4

ER -

Provision of amniotic fluid during parenteral nutrition increases weight gain with limited effects on gut structure, function, immunity, and microbiology in newborn preterm pigs

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