Perinatal factors influencing hepatic glucose-6-phosphatase enzyme activity.
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.


METHODS
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.


CONCLUSIONS
Perinatal events and clinical interventions modulate key enzyme systems necessary for human adaptation to extrauterine life.
Hume
R
R
Department of Obstetrics and Gynecology, Tayside Institute of Child Health, Ninewells Hospital and Medical School, University of Dundee, Scotland. r.hume@dundee.ac.uk
McGeechan
A
A
Burchell
A
A
D001419:Bacteria / Q000302:isolation & purification; D036861:Delivery, Obstetric / Q000379:methods; D005260:Female; D005952:Glucose-6-Phosphatase / Q000378:metabolism*; D006801:Humans; D006947:Hyperkalemia / Q000628:therapy; D007231:Infant, Newborn; D007234:Infant, Premature / Q000378:metabolism*; D008099:Liver / Q000201:enzymology*; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000382:microbiology; D012312:Ritodrine / Q000009:adverse effects; D015149:Tocolytic Agents / Q000009:adverse effects; D014621:Vagina / Q000382:microbiology
D015149:Tocolytic Agents; D005952:Glucose-6-Phosphatase; D012312:Ritodrine