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Inappropriately high plasma insulin levels in suspected perinatal asphyxia
D J Davis1, W D Creery, J Radziuk
1Department of Paediatrics, University of Ottawa, Ontario, Canada.
Acta Paediatrica (Oslo, Norway : 1992)
|March 25, 1999
Summary
Babies with acute neonatal encephalopathy and poor outcomes had higher insulin and C-peptide levels. Inappropriately high insulin may contribute to hypoglycemia and predict poor outcomes in perinatal asphyxia.
Area of Science:
- Neonatology
- Endocrinology
- Perinatal Medicine
Background:
- Acute neonatal encephalopathy (ANE) is a serious condition in newborns.
- Perinatal asphyxia is a common cause of ANE.
- Hormonal imbalances, particularly in glucose regulation, may impact ANE outcomes.
Purpose of the Study:
- To investigate differences in insulin and glucagon levels in infants with ANE due to perinatal asphyxia.
- To correlate these hormone levels with neurodevelopmental outcomes at 18 months.
- To explore the role of hormonal disturbances in ANE pathophysiology and prognosis.
Main Methods:
- Prospective observational study in two tertiary neonatal intensive care units.
- Measured plasma insulin, C-peptide, glucagon, and serum glucose in term infants diagnosed with ANE or perinatal asphyxia.
- Assessed neurodevelopmental outcomes at 18 months of age.
Main Results:
- Infants with poor neurodevelopmental outcomes exhibited significantly higher plasma insulin and C-peptide levels compared to those with good outcomes.
- No significant differences were observed in glucose delivery, serum glucose, or glucagon levels between outcome groups.
- Elevated insulin levels were a frequent finding in infants with significant perinatal or neonatal asphyxia.
Conclusions:
- Inappropriately high insulin levels are common in neonates with significant asphyxia.
- These hormonal disturbances, particularly hyperinsulinemia, may contribute to hypoglycemia and predict poor neurodevelopmental outcomes in ANE.
- Further research into hormonal regulation is crucial for understanding and managing ANE.
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