Latrogenic Hyperinsulinism at Birth

Hormonal and metabolic response to hypoglycaemia in small for gestational age infants.

“…We have previously demonstrated that this is a period during which many metabolic changes occur, even in AGA infants,5 and it is well known that administration of glucose to mothers in labour affects early neonatal blood glucose concentrations. 19 In addition, the insulin/glucose relationship for healthy term neonates, of the same postnatal age, has not yet been documented. Therefore, conclusions drawn from the previous studies of such young infants may not be valid.…”

Effect of labor on maternal dehydration, starvation, coagulation, and fibrinolysis

“…Neonates born to such mothers suffer from hypoglycemia [7,10] similar to neonates born to mothers with diabetes mellitus. Maternal hyperglycemia caused by the acute infusion of glucose solutions may induce hyperglycemia in the fetus.…”

Effect of maternal intrapartum glucose therapy on neonatal blood glucose levels and neurobehavioral status of hypoglycemic term newborn infants

“…Maternal glucose infusion by raising maternal blood glucose level facilitates diffusion of higher amounts of glucose across the placenta to the fetus and causes fetal hyperglycemia [2,5,17, 24] which in turn stimulates fetal insulin [2,9] and inhibits glucagon secretion [10]. Thus a significant increase in fetal/cord plasma insulin [4,11,15] and decrease in glucagon levels [3,11] occurs. These changes in insulin and glucagon levels at birth are expected to increase the glucose utilisation rate, (reviewed by CHEZ [4]), delay hepatic glycogenolysis and gluconeogenesis [13], and thus cause a rapid postnatal fall in the blood glucose levels.…”

“…Experimental studies had shown that infusions of glucose to women prior to delivery causes maternal and transplacental hyperglycemia [2,5,12,17,24] and an increase in fetal insulin levels [2,5,15,17,24]. Prospective studies of infants whose mothers received glucose infusion during induction of epidural or general anesthesia prior to normal or cesarean section delivery, have also shown a rapid postnatal fall in blood glucose level of such infants [11,16].…”