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.
Department of Obstetrics and Gynecology, Tayside Institute of Child Health, Ninewells Hospital and Medical School, University of Dundee, Scotland. r.hume@dundee.ac.uk
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Hume
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McGeechan
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Burchell
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