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Influence of intrauterine growth retardation on parameters of liver function in low birth weight infants
G Boehm1, D M Müller, B Teichmann
1Department of Paediatrics, Karl-Marx-University, Leipzig, German Democratic Republic.
Insights
Small-for-gestational-age (SGA) infants show reduced liver function and metabolic capacity compared to appropriate-for-gestational-age (AGA) infants. These differences in low birthweight (LBW) infants necessitate individualized nutritional management.
Area of Science:
- Neonatalogy
- Pediatric Nutrition
- Metabolic Disorders
Background:
- Low birthweight (LBW) infants require tailored nutritional strategies based on their metabolic status.
- Intrauterine growth restriction impacts infant development and metabolic function.
- Understanding hepatocellular function is crucial for managing LBW infants.
Purpose of the Study:
- To assess hepatocellular function in small-for-gestational-age (SGA) versus appropriate-for-gestational-age (AGA) LBW infants.
- To identify metabolic differences influencing nutritional management in LBW infants.
- To guide individualized nutritional strategies for LBW infants.
Main Methods:
- Measured serum bile acids and alpha-amino-nitrogen in LBW infants.
- Analyzed urinary urea and ammonia excretion.
- Assessed 15N-methacetin metabolism via urinary 15N excretion in SGA and AGA infants.
Main Results:
- SGA infants exhibited higher serum bile acids and alpha-amino-nitrogen than AGA infants.
- SGA infants showed decreased urea and increased ammonia excretion.
- Lower urinary 15N excretion was observed in SGA infants, indicating reduced metabolic capacity.
Conclusions:
- Intrauterine growth retardation affects hepatocellular function and metabolic capacity in SGA infants.
- Significant metabolic differences exist between SGA and AGA LBW infants.
- Individualized nutritional management considering metabolic status is essential for LBW infants.
Abstract:
To establish nutritional management of low birth-weight infants according to their individual metabolic situation, hepatocellular partial function was studied in 13 appropriate (AGA) and 11 small-for-gestational-age (SGA) low birthweight (LBW) infants during the first weeks of postnatal life. The concentrations of total bile acids and of alpha-amino-nitrogen in serum, the renal excretion of urea and ammonia and the renal excretion of 15N after enteral administration of 3 mg 15N-labeled methacetin/kg were measured. In comparison to AGA infants, SGA infants had elevated serum concentrations of total bile acids and of alpha-amino-nitrogen, decreased excretion of urea, increased excretion of ammonia in urine, and lower urinary 15N-excretion after enteral administration of 15N-labeled methacetin. The data suggest that hepatocellular functions are influenced by intrauterine growth retardation resulting in a reduced metabolic capacity in SGA infants. The metabolic differences between SGA and AGA infants should be considered in the nutritional management of LBW infants.