Role of excitatory aminoacids in neonatal hypoglycemia

Abstract Background: Until now, diabetes during pregnancy has been associated with a high risk of maternal, fetal, and neonatal morbidities and mortalities. The main aim of this study was to evaluate the risk factors of hypoglycemia in infants of diabetic mothers (IDMs) and to study the relationship between umbilical cord (UC) C peptide levels and the risk of developing hypoglycemia.Material and methods: UC blood C-peptide and serial serum blood glucose measurements were done for all included singleton newborns born to diabetic mothers during the study period. Maternal and neonatal data such as gestational age, maternal age, maternal weight, types of diabetics and its control, maternal glycated hemoglobin (HbA1C), birth weight, Apgar score, and neonatal complete blood picture were collected.Results: In total, 83 IDMs met the inclusion criteria. Fifty-four (65.06%) developed hypoglycemia and 29 (34.94%) remained normoglycemic. However, there were no significant differences between hypoglycemic and normoglycemic IDMs in terms of types of maternal diabetics (P value = 0.41), its duration (P value= 0.43). The hypoglycemia peak occurred within the first 3 hours of life, with 33.11 ± 8.84 mg/dl for the hypoglycemia group and 54.10 ± 6.66 mg/dl for the normoglycemic group (P value < 0.0001). Most of the babies had no hypoglycemic manifestation (96.30%). Neonates with hypoglycemia their mothers had poor diabetes control in the last trimester (HbA1C 7.09 ± 0.96) compared to normoglycemic babies (HbA1C 6.11 ± 0.38), (P-value < 0.0001). The mean (SD) of UC C-peptide level in hypoglycemic neonates increased to 1.73 ± 1.07 ng/ml compared to normoglycemic ones with 1.08 ± 0.81 ng/ml (P value = 0.005).Conclusion: Poor diabetes control, especially in the last trimester, is associated with neonatal hypoglycemia. Increased UC C-peptide levels could be used as an early indicator for the risk of developing neonatal hypoglycemia and a predictor for babies need neonatal admission.

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Factors Associated with Neonatal Hypoglycemia in Premature Twins and Singletons

Acta geneticae medicae et gemellologiae twin research ◽

10.1017/s0001566000000763 ◽

1997 ◽

Vol 46 (1) ◽

pp. 69-77 ◽

Cited By ~ 4

Author(s):

V. Zanardo ◽

S. Cagdas ◽

F. Marzari

Keyword(s):

Gestational Age ◽

Neonatal Morbidity ◽

Multiple Gestation ◽

Neonatal Hypoglycemia ◽

Factors Associated ◽

Increased Risk ◽

Relative Risk Factor ◽

Per Se ◽

Discordant Twins

AbstractTwin gestation is associated with higher rate of neonatal hypoglycemia than do singletons. We examined the role of specific risk factors associated with neonatal hypoglycemia of 216 premature twins and 1284 premature singletons, consecutively born in the years 1994-1996 in the Department of Pediatrics of Padua University, Italy. Significantly higher risk of hypoglycemia (Dextrostix <40 and <20 mg%) was found in twins vs singletons (54% vs 32%, OR 2.49, CI 1.77-3.56; 19% vs 8%, OR 2.65, CI 1.59-4.19, respectively). Gestational age of 34-37 weeks increased hypoglycemia risk for the premature twins (77% vs 51%, OR 3.20 CI 1.49-6.88). Twin deliveries statistically differed from those of singletons in several perinatal characteristics. More twins were born by cesarean section (85% vs 55%, OR 4.15, CI 2.48-6.95), and the birth weight of twins was much lower related to prematures with BW < 1.0 kg (12% vs 6%, OR 2.06, CI 1.11-3.82) and SGA (20% vs 10%, OR 2.41, CI 1.46-3.98). The risk of twin deliveries was increased at 30-33 weeks gestational age (25% vs 15%, OR 1.84; CI 1.17-2.90). Twins were found to have higher rates of hospitalization (50% vs 40%, OR 1.52, CI 1.04-2.23) and showed an increased risk of cardiorespiratory resuscitation (51% vs 31%, OR 2.36, CI 1.61-3.47), hypothermia (11% vs 4%, OR 3.02, CI 2.333.91), BPD (25% vs 19%, OR 2.55, CI 1.10-5.91), and PVL (4% vs 1%, OR 4.08, CI 1.23-13.5). Mortality was found more often (not significant) in premature twins. The risk for intrapartum and early neonatal morbidity was however, mostly reduced in hypoglycemic twins, while it was comparable between smaller or smaller weight discordant twins and larger twins. Similarly, SGA twins, and smaller or smaller weight-discordant twins did not show increased hypoglycemia risk. In conclusion, our findings suggest that the multiple gestation per se is the single most important relative risk factor of hypoglycemia in premature twins.

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Role of umbilical cord C-peptide levels in early prediction of hypoglycemia in infants of diabetic mothers

BMC Pediatrics ◽

10.1186/s12887-021-02547-w ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Ahlam M. Saber ◽

Magdy A. Mohamed ◽

Abdelrahim A. Sadek ◽

Ramadan A. Mahmoud

Keyword(s):

Umbilical Cord ◽

Diabetes Control ◽

P Value ◽

Maternal Weight ◽

Neonatal Hypoglycemia ◽

C Peptide ◽

Infants Of Diabetic Mothers ◽

Serial Serum ◽

Diabetic Mothers

Abstract Background Until now, diabetes during pregnancy has been associated with a high risk of maternal, fetal, and neonatal morbidities and mortalities. The main aim of this study was to evaluate the risk factors of hypoglycemia in infants of diabetic mothers (IDMs) and to study the relationship between umbilical cord (UC) C peptide levels and the risk of developing hypoglycemia. Material and methods UC blood C-peptide and serial serum blood glucose measurements were done for all included singleton newborns born to diabetic mothers during the study period. Maternal and neonatal data such as gestational age, maternal age, maternal weight, types of diabetics and its control, maternal glycated hemoglobin (HbA1C), birth weight, Apgar score, and neonatal complete blood picture were collected. Results In total, 83 IDMs met the inclusion criteria. Fifty-four (65.06%) developed hypoglycemia and 29 (34.94%) remained normoglycemic. However, there were no significant differences between hypoglycemic and normoglycemic IDMs in terms of types of maternal diabetics (P value = 0.41), its duration (P value = 0.43). The hypoglycemia peak occurred within the first 3 h of life, with 33.11 ± 8.84 mg/dl for the hypoglycemia group and 54.10 ± 6.66 mg/dl for the normoglycemic group (P value < 0.0001). Most of the babies had no hypoglycemic manifestation (96.30%). Neonates with hypoglycemia their mothers had poor diabetes control in the last trimester (HbA1C 7.09 ± 0.96%) compared to normoglycemic babies (HbA1C 6.11 ± 0.38%), (P-value < 0.0001). The mean (SD) of UC C-peptide level in hypoglycemic neonates increased to 1.73 ± 1.07 ng/ml compared to normoglycemic ones with 1.08 ± 0.81 ng/ml (P value = 0.005). Conclusion Poor diabetes control, especially in the last trimester, is associated with neonatal hypoglycemia. Increased UC C-peptide levels could be used as an early indicator for the risk of developing neonatal hypoglycemia and a predictor for babies need neonatal admission.

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Neonatal hypoglycemia and the CPT1A P479L variant in term newborns: A retrospective cohort study of Inuit newborns from Kivalliq Nunavut

Paediatrics & Child Health ◽

10.1093/pch/pxaa039 ◽

2020 ◽

Author(s):

Sorcha A Collins ◽

Gertrude Elizabeth Hildes-Ripstein ◽

James Robert Thompson ◽

Sharon Edmunds ◽

Amber Miners ◽

...

Keyword(s):

At Risk ◽

Retrospective Cohort ◽

Indigenous Populations ◽

Paediatric Society ◽

Neonatal Hypoglycemia ◽

Long Term Outcomes ◽

Maternal Characteristics ◽

Term Newborns

Abstract Introduction Neonatal hypoglycemia (NH) in the first days of life can largely be prevented by recognizing those at risk and managing accordingly. The CPT1A P479L variant is prevalent in northern Indigenous populations and is a possible risk factor for hypoglycemia. We report on NH incidence in the Kivalliq region of Nunavut, where all Inuit newborns are screened for NH. Methods We reviewed clinical charts of 728 Inuit newborns from Kivalliq (January 1, 2010 to December 31, 2013) for blood glucose (BG) levels and infant/maternal characteristics, linking to CPT1A genotype; 616 newborns had BG data from 2 to 48 hours of life. NH was defined using Canadian Paediatric Society guidelines (≤2.0 mmol/L at 2 hours, <2.6 mmol/L at 2 to 48 hours). Results NH was documented in 21.4% overall, 24.4% of at-risk newborns and 19.5% of term newborns with no risk factors (≥37 weeks gestation, term-NRF). NH was documented in 22.0% of CPT1A P479L homozygous, 19.8% of P479L heterozygous and 4.8% of noncarrier term-NRF newborns. With multivariable logistic regression, the adjusted ORs for developing NH in term-NRF newborns was 4.97 for CPT1A P479L homozygotes (95% confidence interval [CI]:0.65–38.35, P=0.19) and 4.71 for P479L heterozygotes (95% CI:0.57–37.89, P=0.15). Conclusion Term-NRF newborns had a higher NH incidence than previously reported, similar to that for at-risk newborns, possibly due to the CPT1A P479L variant. Since only Inuit newborns from Kivalliq are screened for NH, further study of long-term outcomes of NH in this population and the role of the P479L variant are warranted to determine if neonatal BG screening is indicated in all Inuit newborns.

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Role of dactinomycin in the improved survival of children with Wilms' tumor

JAMA ◽

10.1001/jama.195.12.1005 ◽

1966 ◽

Vol 195 (12) ◽

pp. 1005-1009 ◽

Cited By ~ 18

Author(s):

D. J. Fernbach

Keyword(s):

Wilms Tumor

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Role of the allergist in diagnosis and management of patients with uveitis

JAMA ◽

10.1001/jama.195.3.167 ◽

1966 ◽

Vol 195 (3) ◽

pp. 167-172 ◽

Cited By ~ 2

Author(s):

T. E. Van Metre

Keyword(s):

Diagnosis And Management

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The power of norms to sway fused group members

Behavioral and Brain Sciences ◽

10.1017/s0140525x18001644 ◽

2018 ◽

Vol 41 ◽

Cited By ~ 1

Author(s):

Winnifred R. Louis ◽

Craig McGarty ◽

Emma F. Thomas ◽

Catherine E. Amiot ◽

Fathali M. Moghaddam

Keyword(s):

Evolutionary Anthropology ◽

Normative Systems ◽

Violent Extremism ◽

Identity Fusion ◽

Group Members

AbstractWhitehouse adapts insights from evolutionary anthropology to interpret extreme self-sacrifice through the concept of identity fusion. The model neglects the role of normative systems in shaping behaviors, especially in relation to violent extremism. In peaceful groups, increasing fusion will actually decrease extremism. Groups collectively appraise threats and opportunities, actively debate action options, and rarely choose violence toward self or others.

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Elaborating the role of reflection and individual differences in the study of folk-economic beliefs

Behavioral and Brain Sciences ◽

10.1017/s0140525x18000274 ◽

2018 ◽

Vol 41 ◽

Author(s):

Kevin Arceneaux

Keyword(s):

Decision Making ◽

Individual Differences ◽

Cognitive Processes ◽

Evolutionary History ◽

Behavioral Responses ◽

History Of ◽

Economic Beliefs

AbstractIntuitions guide decision-making, and looking to the evolutionary history of humans illuminates why some behavioral responses are more intuitive than others. Yet a place remains for cognitive processes to second-guess intuitive responses – that is, to be reflective – and individual differences abound in automatic, intuitive processing as well.

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