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European Journal of Pediatrics

, Volume 149, Issue 6, pp 396–398 | Cite as

Influence of intrauterine growth retardation on parameters of liver function in low birth weight infants

  • G. Boehm
  • D. M. Müller
  • B. Teichmann
  • P. Krumbiegel
Gastroenterology/Hepatology

Abstract

To establish nutritional management of low birthweight 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 of15N after enteral administration of 3 mg15N-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 urinary15N-excretion after enteral administration of15N-labeled methacetin. The data suggest that hepato-cellular 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.

Key words

Low birth weight infants Small-for-gestationalage Liver functions 

Abbreviations

AGA

appropriate for gestational age

IUGR

intrauterine growth retardation

LBW

low birth weight

SGA

small for gestational age

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References

  1. 1.
    Batshaw ML (1984) Hyperammonemia. Curr Probl Pediatr 14: No 11Google Scholar
  2. 2.
    Boehm G, Senger H, Braun W, Beyreiss K, Räihä NCR (1988) Metabolic differences between AGA- and SGA-infants of very low birthweight. I. Relationship to intrauterine growth retardation. Acta Paediatr Scand 77:19–23PubMedGoogle Scholar
  3. 3.
    Boehm G, Senger H, Müller D, Beyreiss K, Räihä NCR (1988) Metabolic differences between AGA- and SGA-infants of verylow birthweight. II. Relationship to protein intake. Acta Paediatr Scand 77:642–646PubMedGoogle Scholar
  4. 4.
    Boehm G, Gedlu E, Müller DM, Beyreiss K, Räihä NCR (1990) Relationship between urea and ammonia excretion in urine of very low birth weight infants appropriate for gestational age. Biomed Biochim Acta 49 (in press)Google Scholar
  5. 5.
    Bucuvalas IC, Goodrich AL, Blitzer BL, Suchy FI (1985) Amino acids are potent inhibitors of bile acids uptake by liver plasma membrane vesicles isolated from suckling rats. Pediatr Res 19: 1298–1304PubMedGoogle Scholar
  6. 6.
    Cauderay M, Schutz Y, Micheli JL, Calame A, Jequier E (1986) Assessment of protein turnover by 15-N-glycine in SGA and AGS low birthweight infants. Pediatr Res 20:1050 AGoogle Scholar
  7. 7.
    Chessex P, Reichmann B, Verellen G (1984) Metabolic consequences of intrauterine growth retardation in very low birth weight infants. Pediatr Res 18:709–713PubMedGoogle Scholar
  8. 8.
    Cowett R, Susa JB, Oh W, Schwartz R (1984) Glucose kinetics in glucose-infused small for gestational age infants. Pediatr Res 18:74–79PubMedGoogle Scholar
  9. 9.
    De Leeuw R, Kok K, De Vries IJ, Begagnovic N (1985) Tolerance of intravenously administered lipid in newborns. Acta Paediatr Scand 74:52–56PubMedGoogle Scholar
  10. 10.
    Dubowitz LM, Dubowitz V (1977) Clinical assessment for gestational age in the newborn infant. J Pediatr 77:1–19Google Scholar
  11. 11.
    Glasgow JFT, Morre F (1983) Plasma amino acid ratio as an index of hepatocellular maturity in the neonate. Biol Neonate 44:146–152PubMedGoogle Scholar
  12. 12.
    Hay WW (1984) Fetal and neonatal glucose homeostasis and their relation to the small for gestational age infant. Semin Perinatol 8: 101–115PubMedGoogle Scholar
  13. 13.
    Heird WC, Kashyap S, Schulze KF, Ramakrishnan R, Zucker CL, Dell RB (1987) Nutrient utilization and growth in low-birth-weight infants. In: Roy CC (ed) Nutritional requirements of the low-birth-weight neonate. Excerpta Medica: 30–41Google Scholar
  14. 14.
    Krumbiegel P, Hirschberg K, Faust H, Günther K, Schneider G (1985) Nuclear medicine liver-function tests for pregnant women and children. 2. A new test method via urine using15N-methacetin. Eur J Nucl Med 11:58–61CrossRefPubMedGoogle Scholar
  15. 15.
    Lafeber HN, Rolph TP, Jones CT (1984) Studies on the growth of fetal guinea pig. The effects of ligation of the uterine atery on organ growth and development. J Dev Physiol 6:441–459PubMedGoogle Scholar
  16. 16.
    Levitsky LL, Edidin DV, Menella JA, Spaulding NH (1986) The effect of dexamethasone on surgical induced intrauterine growth retardation on renal and hepatic levels of phosphoenolpyruvate carboxykinase in the rat. Biol Neonate 49:36–42PubMedGoogle Scholar
  17. 17.
    Lubchenco LO, Hansman C, Dressler M (1963) Intrauterine growth as estimated from live-born birth weight data at 42-42 weeks' gestation. Pediatrics 32:793–807PubMedGoogle Scholar
  18. 18.
    Ogata ES, Bussey ME, La Barbera A, Finley S (1985) Altered growth, hypoglycemia, and ketonemia in the young rat: postnatal consequences of intrauterine growth retardation. Pediatr Res 19:32–37PubMedGoogle Scholar
  19. 19.
    Richterich R (1965) Klinische Chemie. Karger, BaselGoogle Scholar
  20. 20.
    Sann L, Divry P, Lasne Y, Ruiton A (1982) Effect of oral lipid administration on glucose homeostasis in small for gestational age infants. Acta Paediatr Scand 71:923–927PubMedGoogle Scholar
  21. 21.
    Senger H, Boehm G, Beyreiss K, Braun W, Räihä NCR (1986) Evidence for amino acid induced choestasis in very-low-birth-weight infants with increasing enteral protein intake. Acta Paediatr Scand 75:724–728PubMedGoogle Scholar
  22. 22.
    Senger H, Pludra R, Braun W (1987) Enzymatische Mikrobestimmung der Gesamtgallensäuren im Serum. Z Med Lab Diagn 29: 93–99Google Scholar
  23. 23.
    Stein ZA, Susser M (1984) Intrauterine growth retardation: epidemiological issues and public health significance. Semin Perinatol 8:5–13PubMedGoogle Scholar
  24. 24.
    Tittelbach-Helmrich W, Maser M, Senger H (1983) Bestimmung des alpha-Aminostickstoffs im Serum oder Urin. Zentralbl Pharmacol 122:913–915Google Scholar
  25. 25.
    Warshaw JB (1985) Intrauterine growth retardation: Adaptation or pathology. Pediatrics 76:998–999PubMedGoogle Scholar

Copyright information

© Springer-Verlag 1990

Authors and Affiliations

  • G. Boehm
    • 1
  • D. M. Müller
    • 1
  • B. Teichmann
    • 1
  • P. Krumbiegel
    • 2
  1. 1.Department of PaediatricsKarl-Marx-UniversityLeipzigGerman Democratic Republic
  2. 2.Central Institute for Isotope and Radiation ResearchLeipzigGerman Democratic Republic

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