Related Experiment Videos
Patterns of metabolic adaptation for preterm and term infants in the first neonatal week
J M Hawdon1, M P Ward Platt, A Aynsley-Green
1Department of Child Health, University of Newcastle upon Tyne, Medical School.
Insights
Newborns
Area of Science:
- Neonatal metabolism
- Pediatric endocrinology
Background:
- Limited understanding of neonatal fuel metabolism during the first postnatal week.
- Importance of glucose and alternative fuels in infant adaptation.
- Influence of modern feeding practices on neonatal metabolism.
Purpose of the Study:
- Establish normal ranges for blood glucose and intermediary metabolites in the first postnatal week.
- Investigate interrelationships between fuels in term and preterm infants.
- Compare neonatal metabolic profiles with those of older children.
Main Methods:
- Cross-sectional study design.
- Inclusion of 156 term infants, 62 preterm infants, and 52 older children.
- Analysis of blood glucose and intermediary metabolites.
Main Results:
- Preterm infants exhibited wider blood glucose variation (1.5-12.2 mmol/l) than term infants (1.5-6.2 mmol/l).
- Preterm infants showed low ketone body concentrations, even with low blood glucose.
- Breast/enteral feeding appeared to enhance ketogenic ability in term/preterm infants, respectively.
- Term infants had lower prefeed blood glucose than children but could produce ketone bodies.
Conclusions:
- Neonatal blood glucose must be interpreted alongside other metabolic fuel availability.
- Preterm infants possess a limited capacity to mobilize alternative metabolic fuels.
- Understanding fuel metabolism is crucial for neonatal care, especially in preterm infants.
Abstract:
There have been few comprehensive accounts of the relationships between glucose and other metabolic fuels during the first postnatal week, especially in the context of modern feeding practises. A cross sectional study was performed of 156 term infants and 62 preterm infants to establish the normal ranges and interrelationships of blood glucose and intermediary metabolites in the first postnatal week, and to compare these with those of 52 older children. Blood glucose concentrations varied more for preterm than for term infants (1.5-12.2 mmol/l v 1.5-6.2 mmol/l), and preterm infants had low ketone body concentrations, even at low blood glucose concentrations. Breast feeding of term infants and enteral feeding of preterm infants appeared to enhance ketogenic ability. Term infants had lower prefeed blood glucose concentrations than children but, like children, appeared to be capable of producing ketone bodies. This study demonstrates that neonatal blood glucose concentrations should be considered in the context of availability of other metabolic fuels, and that the preterm infant has a limited ability to mobilise alternative fuels.