Metabolic Fuel and Hormone Responses to Fasting in Newborn Infants

PEDIATRICS ◽  
1979 ◽  
Vol 64 (5) ◽  
pp. 613-619
Author(s):  
Charles A. Stanley ◽  
Endla K. Anday ◽  
Lester Baker ◽  
Maria Delivoria-Papadopolous
Keyword(s):  
Gestational Age ◽  
Plasma Glucose ◽  
Neonatal Period ◽  
Newborn Infants ◽  
Older Children ◽  
Glucose Levels ◽  
Metabolic Fuel ◽  
Healthy Infants ◽  
Lower Plasma Glucose ◽  
Appropriate For Gestational Age

To examine why newborn infants frequently cannot maintain adequate levels of plasma glucose in the interval between delivery and the time they are first fed, circulating metabolic fuel and regulatory hormone concentrations were determined in 44 healthy infants at the end of an eight-hour postnatal fast. Plasma glucose fell below 40 mg/100 ml prior to eight hours in four of 24 term-appropriate-for-gestational-age (AGA), two of nine preterm-AGA, five of six term-small-for-gestational-age (SGA), and three of five preterm-SGA infants. Fuel and hormone patterns in the premature and SGA infants were not different from those found in term-AGA infants. Results in these neonates differed in two areas from the response to fasting seen later in life. In fasted term-AGA infants, ketones were low (β-hydroxybutyrate 0.29 ± 0.04 mM/liter) despite elevated concentrations of fatty acid precursors (1.4 ± 0.07 mM/liter), and the group of infants studied failed to demonstrate the increase in plasma ketones with lower glucose levels (r = +.23, P = .07) which is found in older children. Levels of glucose precursors were two to three times higher in term-AGA infants (lactate 2.9 ± 0.2 mM/liter; alanine 0.48 ± 0.02 mM/liter) than levels found beyond the neonatal period and, in contrast to older children and adults, were not diminished in infants with lower plasma glucose (lactate, r = -.28, P = .035; alanine, r = -.33, P = .02). These differences between the responses to postnatal fasting and those seen beyond the neonatal period suggest that the capacity for both hepatic ketone synthesis and gluconeogenesis is not fully developed at birth.

GROWTH HORMONE LEVELS IN NORMOGLYCEMIC AND HYPOGLYCEMIC INFANTS BORN SMALL FOR GESTATIONAL AGE

PEDIATRICS ◽  
1971 ◽  
Vol 48 (2) ◽  
pp. 190-199
Author(s):  
James R. Humbert ◽  
Ronald W. Gotlin
Keyword(s):  
Growth Hormone ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Gh Deficiency ◽  
Newborn Infants ◽  
Significant Rise ◽  
Glucose Levels ◽  
Appropriate For Gestational Age ◽  
A Prospective Study ◽  
Serum Gh

Recent investigations have raised the possibility that growth hormone (GH) influences intra-uterine weight and length. Moreover, the hypoglycemic tendency of small for gestational age (FSGA) infants and their small size could result from GH deficiency. To verify these hypotheses, a prospective study of daily serum GH and glucose levels was conducted in 46 newborn infants, including 18 FSCA infants, 18-full-term, appropriate for gestational age (FAGA), and 10 premature (PR) infants. Two FSGA babies became hypoglycemic. Both manifested normal GH competence as evidenced by normal daily GH levels, adequate GH response to arginine provocation, and satisfactory growth for over 2 years. Eleven of 12 FSGA babies followed from 14 to 26 months showed no evidence of impaired linear growth. The FSGA babies had GH values similar in magnitude and pattern to those of FAGA and PR infants. During the second half of the first postnatal day, a significant rise in serum GH occurred in all infants regardless of their size or gestational age; this rise may be the result of the stimulating effect of early milk feedings. GH deficiency does not appear to contribute to either the small size or hypoglycemic tendency of FSGA newborn infants.

scholarly journals Umbilical cord ghrelin concentrations in small- and appropriate-for-gestational age newborn infants: relationship to anthropometric markers

2004 ◽  
Vol 180 (2) ◽  
pp. 267-271 ◽  
Author(s):  
EE Onal ◽  
P Cinaz ◽  
Y Atalay ◽  
C Turkyilmaz ◽  
A Bideci ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Cord Blood ◽  
Gestational Age ◽  
Energy Homeostasis ◽  
Newborn Infants ◽  
Fetal Life ◽  
Orexigenic Peptide ◽  
Appropriate For Gestational Age ◽  
The Relationship ◽  
Anthropometric Markers

Ghrelin is a newly discovered orexigenic peptide originating from the stomach. Circulating ghrelin levels reflect acute and chronic energy balance in humans. However, it is not known whether ghrelin also plays a role in energy homeostasis during fetal life. Forty-one small-for-gestational age (SGA) and 34 appropriate-for-gestational age (AGA) infants were studied in order to determine whether cord blood ghrelin concentrations were different in SGA infants compared with AGA infants and the relationship to anthropometric measurements at delivery. The cord blood ghrelin concentrations of SGA infants (means+/-S.E.M.; 15.20+/-3.08 ng/ml) were significantly greater than of AGA infants (2.19+/-0.24 ng/ml) (P<0.0001). They were negatively correlated with the infants' birth weights (r=-0.481, P<0.0001) and with body mass index values (r=-0.363, P<0.001). The higher ghrelin concentrations were found in female infants (20.42+/-4.55 ng/ml) than in males (7.05+/-2.27 ng/ml) in the SGA group (P=0.042). These data provide the first evidence that cord ghrelin levels of SGA infants are greater than those of AGA infants and it is suggested that ghrelin is also affected by nutritional status in the intrauterine period.

scholarly journals The incidence of asymptomatic hypoglycemia in term newborn babies weighing more than two kilograms

2017 ◽  
Vol 4 (4) ◽  
pp. 1267
Author(s):  
Sivaraman Thirumalaikumarasamy ◽  
Ezhilarasu Ramalingam ◽  
Mani Madhavan Sachithanantha Moorthi ◽  
Balakrishnan Nadesan
Keyword(s):  
Birth Weight ◽  
Gestational Age ◽  
Plasma Glucose ◽  
Mode Of Delivery ◽  
Clinical Signs ◽  
Glucose Infusion ◽  
College Hospital ◽  
Glucose Levels ◽  
Significant Difference ◽  
Parity Mode

Background: Neonatal hypoglycemia is a common metabolic problem especially in cases like prematurity, sepsis and small gestational age. Episodes of asymptomatic hypoglycemia may occur due to many risk factors. The present study aimed to evaluate the incidence of asymptomatic hypoglycemia in term new born babies weighing more than 2 kg, to study the plasma sugar level at various time points during first 48 hours of life and to study the effect of maternal factors like parity, mode of delivery, glucose infusion during labour, and time since last feed on plasma sugar level.Methods: A hospital based longitudinal study was conducted over a period of one year from April 2005 to March 2006 in Kilpauk Medical College Hospital, Chennai. 400 babies born of consecutive deliveries were included in the study. Their plasma glucose levels were assessed in cord blood, 3 hr, 12 hr and 36 hr of life. Plasma glucose levels were analysed with regards to distribution, variables like parity, mode of delivery, dextrose infusion during labour and time since last feed. The plasma glucose levels were statistically analysed by paired student ‘t’ test, multiple analysis of variance (ANOVA), chi- square test using SPSS (version 7.5) statistical package.Results: The overall incidence of hypoglycemia was seen in 20% of the neonate’s in which 29.7% in small gestational age (SGA) and 16.7% in appropriate gestational age (AGA) babies. A significant (p <0.01) association between hypoglycemia and birth weight was observed. The association between hypoglycemia with parity, mode of delivery, sex of the baby and glucose infusion received by the mother was studied, but no significant association was found. A significant difference in plasma glucose based on birth weight at 3rd hour, 12th hour and 36th hour was observed (p <0.05). None of the infants showed any clinical signs of hypoglycemia.Conclusions: The incidence of hypoglycemia was noted in 20% of the neonates. Low birth weight was considered as risk factor. A significant association was also observed between plasma glucose, mode of delivery and time since last fed. 

scholarly journals Plasma glucose levels in the association between serum trans-β-carotene and obesity among children and adolescents

2020 ◽  
Author(s):  
xiaodong zang ◽  
Hui Liu ◽  
Junqiang Zheng ◽  
Ming Fan ◽  
Xian Shen ◽  
...  
Keyword(s):  
Plasma Glucose ◽  
Inflection Point ◽  
Continuous Variable ◽  
P Value ◽  
Inverse Association ◽  
Linear Regression Models ◽  
Lower Plasma ◽  
Glucose Levels ◽  
Lower Plasma Glucose ◽  
Β Carotene

Abstract Background Results on the association between trans-β-carotene and obesity are less clear and little is known about how their relationship may be affected by plasma glucose levels.The present study aimed to evaluate the relationships between trans-β-carotene and obesity and to investigate whether plasma glucose levels had a modifying effect on these relationships. Methods Children aged 6-18 years were selected from the National Health and Nutrition Examination Survey(NHANES) (2001–2006) (n =8030). The serum trans-β-carotene levels were divided into tertiles, and their associations with obesity were evaluated using multivariable-adjusted linear regression models adjusted for potential confounding factors. The interaction effects between trans-β-carotene levels and plasma glucose levels on obesity were further evaluated. Results In the fully adjusted model, using serum trans-β-carotene as natural log-transformed continuous variable, the negative association between trans-β-carotene level and obesity were confirmed. In addition, plasma glucose levels significantly modified the inverse association between trans-β-carotene and obesity (p value for interaction: 0.09). A stronger association of trans-β-carotene levels with obesity was found in higher plasma glucose levels (more than100 mg/dl) than in lower plasma glucose levels. Further, a non-linear relationship was detected between trans-β-carotene and obesity in participants with higher plasma glucose levels, with an inflection point of 2.7 (trans-β-carotene =14.88 ug/dl). The effect sizes and confidence intervals for the left and right sides of the inflection point were 0.10 (0.00 to 0.2) and 6.7 (0.1 to 348.2), respectively. Conclusion Our findings indicate that the association between trans-β-carotene concentration and obesity is stronger in individuals with higher plasma glucose population than in those with lower plasma glucose levels.

THE RESPONSE OF INFANTS OF DIABETIC WOMEN TO TOLBUTAMIDE AND LEUCINE AT BIRTH, AND TO GLUCOSE AND TOLBUTAMIDE AT 2 YEARS OF AGE

PEDIATRICS ◽  
1969 ◽  
Vol 43 (4) ◽  
pp. 546-557
Author(s):  
Mutya S. A. Velasco ◽  
Elsa P. Paulsen
Keyword(s):  
Glucose Tolerance ◽  
Plasma Glucose ◽  
Newborn Infants ◽  
Normal Glucose Tolerance ◽  
Diabetic Woman ◽  
Oral Glucose ◽  
Insulin Levels ◽  
Glucose Levels ◽  
Normal Glucose ◽  
Diabetic Mothers

Twelve newborn infants, 2 to 8 days old, of gestational (IGDM) and insulin-requiring (IDM) diabetic mothers responded to intravenous tolbutamide (20 mg/kg) with abnormally large decreases in plasma glucose and marked rises in plasma insulin (the latter was measured only in IGDM). Only 3 of 13 IGDM tested with leucine had significant decreases in plasma glucose. Newborn infants of normal mothers showed no changes in glucose or insulin in response to intravenous tolbutamide, and one of five had a small decrease in glucose levels after leucine. The results suggest the presence of large stores of pancreatic insulin in newborn infants of diabetic mothers which are more readily released by stimulation with tolbutamide than with leucine. The offspring of the diabetic women were restudied at 2 years of age for their response to intravenous tolbutamide and oral glucose. Seven of nine children had normal glucose and insulin levels after intravenous tolbutamide, and two had abnormally low glucose levels with high insulin levels. Three of the nine had normal glucose tolerance with normal insulin levels. The other six had abnormally elevated glucose levels which varied in duration from one-half to 2 hours. Four of the six had an accompanying hyperinsulinemia; two, who had diabetic glucose tolerance, had poor insulin responses. The findings in the 2-year-old children support a concept that the fetal environment provided by a diabetic woman has effects on carbohydrate tolerance which extend beyond the newborn period.

Perinatal outcome in diabetic mothers with relation to glycemic control during pregnancy.

2021 ◽  
Vol 28 (03) ◽  
pp. 382-386
Author(s):  
Jawaria Rasheed ◽  
Saira Isa ◽  
Faizza Rasheed ◽  
Kashif Siddiq ◽  
Zahida Saqlain ◽  
...  
Keyword(s):  
Gestational Age ◽  
Plasma Glucose ◽  
Birth Asphyxia ◽  
Perinatal Outcomes ◽  
High Plasma ◽  
Large For Gestational Age ◽  
Mean Values ◽  
Glucose Levels ◽  
High Plasma Glucose ◽  
Diabetic Mothers

Objective: To determine the frequency of perinatal outcomes (macrosomia, large for gestational age, birth asphyxia) in pregnant diabetic women with low and high plasma glucose levels between 36-40 weeks. Study Design: Cross-sectional study. Setting: Department of Obstetrics & Gynaecology, DHQ Hospital, Lodhran. Period: 2017 to 2019. Material & Methods: Total 285 diabetic women of age 25-40 years with singleton pregnancy of gestational age 36-40 weeks were selected. Patients with multiple pregnancies, GDM, renal disease and hypertension were excluded. Plasma glucose levels (fasting & 2 hour post-prandial) measured and mean values (fasting + postprandial/2) calculated. The mean values falling between 100-139 mg/dl were taken as low plasma glucose level where as ≥140 mg/dl noted as high plasma glucose level. The perinatal outcomes (macrosomia, large for gestational age, birth asphyxia) were assessed at the time of delivery. Results: Mean age was 29.44 ± 6.01 years. Mean plasma glucose levels were 109.77 ± 6.81 mg/dl. Perinatal outcome i.e. macrosomia, large for gestational age infants and birth asphyxia was found in 7.72%, 27.37% and 22.81% respectively. In this study that pregnant women with mean plasma glucose of 100-139 mg/dl showed frequency of macrosomia by 3.59%, large for gestational age 16.17% and birth asphyxia 14.35% while women with mean plasma glucose of ≥140 mg/dl showed frequency of macrosomia by 13.56%, large for gestational Age 43.22% and birth asphyxia 34.75%. Conclusion: Pregnant diabetic women with high plasma glucose levels have significantly high percentage of large for gestational age, birth asphyxia and macrosomia as compared to diabetic mothers with low plasma blood glucose levels. Consider diabetic mothers at risk and implement efficacious treatment in order to reduce the perinatal complications.

scholarly journals PNEUMOTHORAX – RISK FACTORS IN NEWBORN INFANTS

2016 ◽  
Vol 65 (3) ◽  
pp. 268-270
Author(s):  
Aniko Manea ◽  
◽  
Daniela Cioboata ◽  
Florina Doandes ◽  
Delia Nicoara ◽  
...  
Keyword(s):  
Risk Factors ◽  
Retrospective Study ◽  
Birth Weight ◽  
Respiratory Distress Syndrome ◽  
Gestational Age ◽  
Distress Syndrome ◽  
Neonatal Period ◽  
Newborn Infants ◽  
Study Group ◽  
Important Condition

Aim. The main purpose is to evaluate the predisposing factors, the evolution and the associated pathology of the pneumothorax in the neonatal period. Materials and methods. Retrospective study over two years between 2014 and 2015 on 11 patients hospitalized in the Neonatology department of “Louis Turcanu” Children’s Emergency Hospital, Timisoara, diagnosed with pneumothorax. Results. From 1689 newborn infants admitted, 11 patients developed pneumothorax, the incidence was 0.65%. 8 patients (73%) were males and 3 (27%) were females. 4 out of those 11 patients were term newborn infants (gestational age >37 weeks) and 7 patients were premature newborns (<37 weeks of gestational age). Based on the birth weight 4 patients had over 2,500 grams and 7 under 2,500 grams. The main cause of the pneumothorax in the study group was the respiratory distress syndrome (45,4%). Conclusions. Pneumothorax represents an important condition in the neonatal pathology, it is essential to recognize and initiate the treatment from early stages to reduce the complications.

scholarly journals Frequency of Neonatal Hypoglycemia in Large for Gestational Age Infants of Non-Diabetic Mothers in a Community Maternity Hospital

2006 ◽  
Vol 49 (4) ◽  
pp. 237-239 ◽  
Author(s):  
Nilgun Araz ◽  
Mustafa Araz
Keyword(s):  
Blood Glucose ◽  
Gestational Age ◽  
Maternity Hospital ◽  
Large For Gestational Age ◽  
Control Group ◽  
Neonatal Hypoglycemia ◽  
Glucose Levels ◽  
Increased Risk ◽  
Appropriate For Gestational Age ◽  
Diabetic Mothers

Large for gestational age (LGA) infants are at increased risk for hypoglycemia. The aim of the study was to determine the frequency of neonatal hypoglycemia in LGA infants of non-diabetic mothers in a Community Maternity Hospital in Gaziantep, Turkey. Hospital records of 5229 infants of non-diabetic mothers were examined retrospectively. Newborns with birth weight more than 4000 g were defined as LGA. The control group consisted of 100 appropriate for gestational age (AGA) newborns. Capillary blood glucose was measured at the second hour of life. Glucose values lower than 40 mg/dL (2.2 mmol/L) were defined as hypoglycemia. Ninety-six (1.8%) of the 5229 infants were found to be LGA. The mean capillary glucose levels of the LGA newborns were significantly lower than those of the AGA newborns (54 mg/dL (3.0 mmol/L) vs. 95 mg/dL (5.2 mmol/L), p<0.0001). Neonatal hypoglycemia was established in 16 of 96 LGA infants (16.7%). In the control group hypoglycemia was absent. The rate of hypoglycemia in LGA infants was significantly higher than the rate in the AGA infants (p=0.0000). As hypoglycemia is not rare in LGA infants and can have serious consequences, blood glucose levels should be screened routinely in LGA infants.

scholarly journals Incidence of hypoglycaemia within 72 hours after birth in low birth weight babies who are appropriate for gestational age

2018 ◽  
Vol 5 (3) ◽  
pp. 944
Author(s):  
M. Amarendra ◽  
Rajesh Kumar Sethi ◽  
V. Prudhviraju Pericherla
Keyword(s):  
Blood Glucose ◽  
Birth Weight ◽  
Breast Milk ◽  
Low Birth Weight ◽  
Gestational Age ◽  
Common Symptom ◽  
Neonatal Hypoglycemia ◽  
Maternal Risk ◽  
Glucose Levels ◽  
Appropriate For Gestational Age

Background: Neonatal hypoglycemia is a very common metabolic disorder which is due to inability to maintain a normal glucose homeostasis. The most effective method of preventing hypoglycemia is early breast feeding which is preferred to formula feeding. Therefore, author conducted this study to document incidence of hypoglycemia both symptomatic and asymptomatic in exclusively fed with breast milk, low birth weight neonates who are appropriate for gestational age. Aims and objectives of this study was to determine incidence of hypoglycaemia in first 72 hrs of life in low birth weight neonates (1500-2499gm) who are appropriate for gestational age and who are exclusively fed with breast milk.Methods: Prospective cohort study conducted in between December 2015 to November 2017 in which 150 consecutive neonates with a birth weight between 1500 to 2499 grams and appropriate for gestational age, being fed exclusively with breast milk were studied.Results: Out of 150 neonates, 36 (24%) developed one episode of hypoglycemia, 14 (9.4%) newborns had recurrent episodes while 13 (8.66%), and 1 (0.7%) newborn had two and three episodes of hypoglycemia respectively. Applying a cut-off of blood glucose level of 40 mg/dl, the incidence of hypoglycemia was 24%. The less is the gestational age there is higher chance of occurrence of hypoglycemia. PIH is the most common maternal risk factor for neonatal hypoglycemia. Incidence of hypoglycemia is highest during the first 24hrs after birth and jitteriness is the most common symptom of neonatal hypoglycemia.Conclusions: Healthy new-borns in postnatal wards can be exclusively breastfed, but there is needing to closely monitor their blood glucose levels at least in first 72 hrs and asymptomatic hypoglycaemia in new-borns can be managed with frequent breastfeeding without any formula feeds.

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