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Metabolic adaptation at birth

Martin Ward Platt1, Sanjeev Deshpande

  • 1Newcastle Neonatal Services, Royal Victoria Infirmary, Department of Child Health, Queen Victoria Road, Newcastle upon Tyne NE1 4 LP, UK. m.p.ward-platt@ncl.ac.uk

Seminars in Fetal & Neonatal Medicine
|May 27, 2005
PubMed

Insights

Newborn infants adapt to a fat-based fuel economy after birth. Preterm and growth-restricted infants face challenges in this metabolic transition, risking impaired ketogenesis and altered insulin response.

Area of Science:

  • Neonatal physiology
  • Metabolic adaptation
  • Endocrinology

Background:

  • Newborns transition from placental glucose to fat-based metabolism post-birth.
  • Term infants typically achieve this metabolic shift via coordinated hormonal and metabolic changes.
  • Preterm and intrauterine growth-restricted infants exhibit distinct adaptive patterns.

Purpose of the Study:

  • To examine the metabolic and hormonal adaptations in neonates after birth.
  • To compare the adaptive responses of term, preterm, and growth-restricted infants.
  • To identify risks associated with impaired metabolic adaptation in vulnerable neonates.

Main Methods:

  • Observational study comparing metabolic profiles of different neonatal groups.
  • Analysis of hormonal responses (e.g., insulin secretion) to blood glucose levels.
  • Assessment of ketogenesis capacity in term, preterm, and growth-restricted neonates.

Main Results:

  • Preterm and growth-restricted infants show impaired counter-regulatory ketogenesis.
  • Neonatal insulin secretion is less precisely linked to blood glucose in these groups.
  • Feeding practices significantly influence metabolic adaptation patterns.

Conclusions:

  • Vulnerable neonates (preterm, growth-restricted) are at higher risk for metabolic disturbances.
  • Understanding these differences is crucial for appropriate neonatal care and feeding strategies.
  • Further research into optimizing metabolic adaptation in high-risk infants is warranted.

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