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Intrauterine growth restriction and postnatal steroid treatment effects on insulin sensitivity in preterm neonates

Jaana A Leipälä1, Kari O Raivio, Annikki Sarnesto

  • 1Hospital for Children and Adolescents, University of Helsinki, Finland.

The Journal of Pediatrics
|October 16, 2002
PubMed

Insights

Intrauterine growth restriction (IUGR) in preterm infants does not affect insulin sensitivity. However, early steroid treatment in small for gestational age (SGA) infants significantly decreases their insulin sensitivity.

Area of Science:

  • Neonatal physiology
  • Endocrinology
  • Perinatal medicine

Background:

  • Intrauterine growth restriction (IUGR) is a significant concern in neonatology.
  • Insulin plays a crucial role in fetal growth and development.
  • The impact of early glucocorticoid therapy on neonatal insulin sensitivity requires further investigation.

Purpose of the Study:

  • To assess insulin sensitivity in preterm infants with and without IUGR.
  • To determine the effect of glucocorticoid therapy on insulin sensitivity in these infants.

Main Methods:

  • Utilized a modified minimal model test to measure insulin sensitivity index (S(I)) in preterm infants.
  • Classified infants into appropriate for gestational age (AGA) and small for gestational age (SGA) groups based on birth weight.
  • Administered systemic steroids to a subset of both AGA and SGA infants.

Main Results:

  • No significant difference in basal insulin/glucose ratio or S(I) was observed between AGA and SGA infants.
  • Glucocorticoid therapy did not affect insulin sensitivity in AGA infants.
  • Steroid treatment significantly decreased insulin sensitivity in SGA infants (P <.05).

Conclusions:

  • The modified minimal model is a viable method for assessing neonatal insulin sensitivity.
  • IUGR is not associated with impaired fetal glucose tolerance.
  • Early neonatal steroid administration reduces insulin sensitivity in SGA infants, potentially increasing hyperglycemia risk.
Abstract

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