Perinatal factors influencing hepatic glucose-6-phosphatase enzyme activity

J Perinatol. Jul-Aug 2000;20(5):301-6. doi: 10.1038/sj.jp.7200379.

Abstract

Background: At discharge from neonatal units, many preterm infants are vulnerable to preprandial hypoglycemia due to insufficient liver glucose production. In most preterm infants, hepatic glucose-6-phosphatase activity (the terminal step of liver glucose production) remains abnormally low postnatally.

Objective: To determine what perinatal factors are associated with changes in hepatic glucose-6-phosphatase enzyme activity.

Study design: The maximum velocity (Vmax) of the hepatic microsomal glucose-6-phosphatase enzyme, as the dependent variable, was correlated by stepwise multiple regression analysis with clinical data from a consecutive series of 45 preterm infants from a level 3 neonatal unit.

Results: Significant factors (p < or = 0.0005) were the presence of pathogenic bacteria isolated from maternal high vaginal swabs (p < or = 0.0000), hyperkalemia regimen, duration of prenatal exposure to ritodrine, and delivery mode. Further analysis revealed that the highest correlation was with positive early post-delivery infant bacterial cultures.

Conclusion: Perinatal events and clinical interventions modulate key enzyme systems necessary for human adaptation to extrauterine life.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Bacteria / isolation & purification
  • Delivery, Obstetric / methods
  • Female
  • Glucose-6-Phosphatase / metabolism*
  • Humans
  • Hyperkalemia / therapy
  • Infant, Newborn
  • Infant, Premature / metabolism*
  • Liver / enzymology*
  • Pregnancy
  • Pregnancy Complications, Infectious / microbiology
  • Ritodrine / adverse effects
  • Tocolytic Agents / adverse effects
  • Vagina / microbiology

Substances

  • Tocolytic Agents
  • Glucose-6-Phosphatase
  • Ritodrine