Early Life Stress, DNA Methylation of NR3C1 and HSD11B2 , and Oral Feeding Skill Development in Preterm Infants : A Pilot Study.
Thao Griffith, Dina Tell, Stefan J Green and 6 others
PMID 39724562WHAT IT FOUND
In 10 preterm infants, acute NICU stress and higher methylation at certain stress-related gene sites tracked with poorer oral-feeding engagement and stability and slower transition to full oral feeds; chronic stress did not track with feeding scores.
Key findings
01More frequent acute stress events were associated with lower engagement and physiologic stability scores and a longer transition from first to full oral feeding.
02Higher methylation at CpG 17 and CpG 31 was associated with more acute and chronic stress, lower engagement and physiologic stability, and longer transition to full oral feeding.
03Hours of chronic stress were not associated with any Early Feeding Skills Assessment subscale.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPsWhat it means for RNs
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What it does not show
Only 10 infants were analysed, and no power analysis was done, so the study cannot support general conclusions about preterm infants. Analyses were exploratory and did not correct for multiple comparisons, so some associations could be chance findings. Stress was measured indirectly from medical records using the Neonatal Infant Stressor Scale, and researchers were not blinded to stress data. Feeding skills were judged at the bedside by the principal investigator or speech therapist, which may introduce subjective bias compared with objective swallow studies. Infants had a wide range of gestational ages, and gestational age was not controlled, which may confound stress and feeding results. DNA methylation was measured at selected CpG sites in buccal cells at one time point, and tissue specificity and other stress-related genes were not addressed. Whether the low methylation percentages are biologically meaningful remains unclear. Spanish-speaking families were not recruited, so the sample may not represent all NICU families.
Declared interests
The authors declare no conflicts of interest, and there are no financial or competing interests to claim for any of the authors.
The easy way to misread this
Do not conclude that reducing NICU stress will improve oral feeding or that DNA methylation causes delayed feeding. This was a pilot study of 10 infants with associations only, no tested intervention, and no correction for multiple comparisons.