Perinatal Factors Influencing Hepatic Glucose-6-Phosphatase Enzyme Activity

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 (V_max) of the hepatic microsomal glucose-6-phosphatase enzyme, as the dependant 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 ≤ 0.0005) were the presence of pathogenic bacteria isolated from maternal high vaginal swabs (p ≤ 0.0000), hyperkalemia regimen, duration of prenatal exposure to ritodrine, and delivery mode. Further analysis revealed that the highest correlation was with positive early postdelivery infant bacterial cultures.

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