{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T05:35:14Z","timestamp":1793424914685,"version":"4.5.0"},"reference-count":20,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T00:00:00Z","timestamp":1788134400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Feeding intolerance (FI) is a common morbidity in preterm infants, often preceding necrotizing enterocolitis (NEC). Near-infrared spectroscopy (NIRS) monitoring of abdominal regional oxygen saturation (A-rSO2) may detect impaired intestinal hemodynamics before clinical symptoms appear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To investigate the relationship between A-rSO2 patterns and feeding tolerance in preterm infants.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A prospective observational cohort study of 30 preterm infants &amp;lt;37 weeks of gestation admitted at Dongguan Children's Hospital Affiliated to Guangdong Medical University between December 2020 to September 2021. A-rSO2 was measured pre-prandially (mean over a 10\u2005min stable period) and post-prandially (mean commencing 30\u2005min after feeding). Infants were stratified into FI (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20097) and feeding tolerance (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200923) groups based on clinical criteria. Univariate and multivariate logistic regression analyses were performed to identify factors associated with FI. Given the small sample size, the regression analysis is exploratory.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The incidence of FI was 23.3%, and NEC was 10%. Infants with FI had significantly lower gestational age (32.1 vs. 35.2 weeks,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.003) and lower birth weight (1.76 vs. 2.43\u2005kg,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.008). Multivariate analysis identified lower gestational age [adjusted OR (aOR): 0.505, 95% CI: 0.286\u20130.891] and a postprandial decline in A-rSO\u2082 (aOR: 13.03, 95% CI: 1.352\u2013125.6) as independent factors associated with FI. Conversely, preterm formula feeding was associated with a significantly reduced odds of FI (aOR: 0.055, 95% CI: 0.004\u20130.762). The exploratory model demonstrated good discrimination (AUC=0.867, 95% CI: 0.763\u20130.964) and adequate calibration (Hosmer-Lemeshow\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.612). At the optimal cutoff probability of 0.384, sensitivity was 85.7% and specificity 82.6%. Internal bootstrap validation confirmed model robustness (optimism-corrected C-statistic\u2009=\u20090.867). Infants with NEC (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20093) demonstrated significantly lower preprandial oxygenation and a greater postprandial change in oxygenation index.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>A postprandial decline in A-rSO2 may be a potential factor associated with feeding intolerance in preterm infants. NIRS monitoring of intestinal oxygenation provides a physiological indicator that warrants further investigation as a factor associated with gut dysfunction. These findings are hypothesis-generating and require validation in larger cohorts.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fped.2026.1874181","type":"journal-article","created":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T05:40:42Z","timestamp":1788154842000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Postprandial decline in abdominal regional oxygen saturation is associated with feeding intolerance in preterm infants: a prospective cohort study"],"prefix":"10.3389","volume":"14","author":[{"given":"Bang","family":"Du","sequence":"first","affiliation":[{"name":"Department of Neonatology, Dongguan Children\u2019s Hospital Affiliated to Guangdong Medical University","place":["Dongguan, Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fengmin","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Neonatology, Dongguan Children\u2019s Hospital Affiliated to Guangdong Medical University","place":["Dongguan, Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoguang","family":"He","sequence":"additional","affiliation":[{"name":"Department of Neonatology, Dongguan Children\u2019s Hospital Affiliated to Guangdong Medical University","place":["Dongguan, Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Baimao","family":"Zhong","sequence":"additional","affiliation":[{"name":"Department of Neonatology, Dongguan Children\u2019s Hospital Affiliated to Guangdong Medical University","place":["Dongguan, Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,31]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"134","DOI":"10.1016\/j.jnn.2016.09.009","article-title":"Feeding intolerance, inflammation, and neurobehaviors in preterm infants","volume":"23","author":"Moore","year":"2017","journal-title":"J Neonatal Nurs"},{"key":"B2","doi-asserted-by":"publisher","first-page":"105601","DOI":"10.1016\/j.earlhumdev.2022.105601","article-title":"Feeding intolerance","volume":"171","author":"Ortigoza","year":"2022","journal-title":"Early Hum Dev"},{"key":"B3","doi-asserted-by":"publisher","first-page":"259","DOI":"10.1007\/s40272-024-00626-w","article-title":"Neonatal necrotizing enterocolitis: an update on pathophysiology, treatment, and prevention","volume":"26","author":"Roberts","year":"2024","journal-title":"Paediatr Drugs"},{"key":"B4","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1053\/j.semperi.2016.09.015","article-title":"Pathogenesis of NEC: impact of an altered intestinal microbiome","volume":"41","author":"Neu","year":"2017","journal-title":"Semin Perinatol"},{"key":"B5","doi-asserted-by":"publisher","first-page":"433","DOI":"10.1111\/apa.15559","article-title":"Pathogenesis of necrotising enterocolitis: the impact of the altered gut microbiota and antibiotic exposure in preterm infants","volume":"110","author":"Raba","year":"2021","journal-title":"Acta Paediatr"},{"key":"B6","doi-asserted-by":"publisher","first-page":"550","DOI":"10.1097\/MPG.0000000000001308","article-title":"Splanchnic oxygenation at first enteral feeding in preterm infants: correlation with feeding intolerance","volume":"64","author":"Corvaglia","year":"2017","journal-title":"J Pediatr Gastroenterol Nutr"},{"key":"B7","doi-asserted-by":"publisher","first-page":"755","DOI":"10.1097\/MPG.0000000000001804","article-title":"Feed-related splanchnic oxygenation in preterm infants with abnormal antenatal Doppler developing gut complications","volume":"66","author":"Martini","year":"2018","journal-title":"J Pediatr Gastroenterol Nutr"},{"key":"B8","doi-asserted-by":"publisher","first-page":"716","DOI":"10.1038\/s41372-022-01576-2","article-title":"Abdominal near infrared spectroscopy can be reliably used to measure splanchnic oxygenation changes in preterm infants","volume":"43","author":"Thomas","year":"2023","journal-title":"J Perinatol"},{"key":"B9","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1097\/00000658-197801000-00001","article-title":"Neonatal necrotizing enterocolitis. 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