Epigenetic investigation into <i>NR3C1</i> exon 1F and <i>HSD11B2</i>: associations with neurodevelopment and oral feeding skills in preterm infants

<h4>Aims</h4>To examine the relationship between DNA methylation of <i>NR3C1</i> exon 1F and <i>HSD11B2</i> promoters and neurodevelopment, and oral feeding skills in preterm infants.<h4>Design</h4>A longitudinal prospective cohort study was conducted.<h4>Methods</h4>Data from 61 preterm infants who were born between 26 to 34 weeks gestational age without major comorbidities were analyzed. DNA methylation was evaluated from buccal samples. Neurodevelopment and oral feeding skills were evaluated using the Neurobehavioral Assessment of the Preterm Infants and the Early Feeding Skills Assessment, respectively.<h4>Results</h4>Increased methylation at specific cytosine-guanine (CpG) dinucleotide sites within <i>NR3C1</i> exon 1F and <i>HSD11B2</i> promoters was associated with suboptimal neurodevelopmental and oral feeding outcomes, potentially reflecting heightened sensitivity to early life stress in the NICU. Conversely, certain methylation changes appear to be adaptive, promoting consistent suck-breathe coordination, or optimal behavioral and cardiorespiratory stability during oral feeding.<h4>Conclusion</h4>The study highlights the complex relationship between DNA methylation of <i>NR3C1</i> exon 1F and <i>HSD11B2</i> promoters and neurodevelopment, and oral feeding skills in preterm infants.<h4>Implications for the profession and/or patient care</h4>Findings emphasize the need for continued research into epigenetic mechanisms underlying neonatal adaptation and stress regulation, with potential implications for targeted epigenetic interventions to support optimal neurodevelopment and oral feeding skills.