Neonatal blood glucose concentrations in caesarean and vaginally delivered term infants

Marom, Ronella; Dollberg, Shaul; Mimouni, Francis; Berger, I; Mordechayev, Nina; Ochshorn, Yifat; Mandel, Dror

doi:10.1111/j.1651-2227.2010.01865.x

Cited by 27 publications

(29 citation statements)

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“…There are many fetal and perinatal complications of cesarean delivery e.g. obesity, allergies, metabolic disturbance, and lower blood glucose levels in the offspring [3-6]. …”

Section: Letter To the Editormentioning

confidence: 99%

Low neonatal blood glucose levels in cesarean-delivered term newborns at Khartoum Hospital, Sudan

et al. 2014

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BackgroundGlucose is the main source of energy for organ function in neonates. There are few published recent data on neonatal glucose levels during cesarean delivery.MethodsA case (cesarean delivery) -control (vaginal delivery) study was conducted at Khartoum Hospital Sudan to compare blood glucose levels of term newborns born after elective cesarean delivery with those born vaginally.ResultsCord blood glucose levels at delivery were significantly lower in women who had a cesarean delivery compared with those who delivered vaginally (99.8 ± 20.6 vs. 106.8 ± 11.1 mg/dl, P = 0.026), but there was no significant difference (97.8 ± 16.7 vs. 102.1 ± 9.6, P = 0.110) in newborn glucose levels at 2 hours after delivery between the groups. In linear regression, cesarean delivery (-6.475 mg/dl, P = 0.013) and maternal blood glucose levels at the time of delivery (+0.619 mg, P < 0.001) were significantly associated with mean cord glucose levels.ConclusionThis study shows that cord blood glucose levels are significantly lower in cesarean-delivered neonates than vaginally-delivered neonates. In addition, cord blood glucose levels are significantly associated with cesarean delivery and maternal blood glucose levels at delivery.Virtual SlidesThe virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/2011479878124993

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“…There are many fetal and perinatal complications of cesarean delivery e.g. obesity, allergies, metabolic disturbance, and lower blood glucose levels in the offspring [3-6]. …”

Section: Letter To the Editormentioning

confidence: 99%

Low neonatal blood glucose levels in cesarean-delivered term newborns at Khartoum Hospital, Sudan

et al. 2014

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“…The implication of these studies is that fetal AMCs are capable of responding to hypoglycemia with inappropriately timed catecholamine secretion. On the other hand, the transport of wastes and nutrients across the umbilical cord is of necessity occluded at birth, and blood glucose decreases to a nadir of about 2-3 mM during the first 2 h of life before stabilizing at a higher level (26,30,39,51,54). Tissue concentrations of glucose are likely to be much lower at this time given that, during hypoglycemia, interstitial glucose can decrease to ϳ34% of plasma glucose (37).…”

Section: Discussionmentioning

confidence: 99%

“…As a result, fetuses are completely dependent on their mothers for the transplacental facilitated diffusion of glucose. During normal birth, this transport ceases, leading to a decrease in blood glucose (hypoglycemia) in the first few hours of life (26,30,39,51,54). In the newborn, hypoglycemia activates a counterregulatory surge in catecholamines and glucagon and a fall in insulin (11).…”

mentioning

confidence: 99%

Low glucose sensitivity and polymodal chemosensing in neonatal rat adrenomedullary chromaffin cells

Livermore

Piskuric

Buttigieg

et al. 2011

American Journal of Physiology-Cell Physiology

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Livermore S, Piskuric NA, Buttigieg J, Zhang M, Nurse CA. Low glucose sensitivity and polymodal chemosensing in neonatal rat adrenomedullary chromaffin cells. Am J Physiol Cell Physiol 301: C1104 -C1115, 2011. First published July 20, 2011 doi:10.1152/ajpcell.00170.2011Glucose is the primary metabolic fuel in mammalian fetuses, yet mammals are incapable of endogenous glucose production until several hours after birth. Thus, when the maternal supply of glucose ceases at birth there is a transient hypoglycemia that elicits a counterregulatory surge in circulating catecholamines. Because the innervation of adrenomedullary chromaffin cells (AMCs) is immature at birth, we hypothesized that neonatal AMCs act as direct glucosensors, a property that could complement their previously established roles as hypoxia and acid hypercapnia sensors. During perforated-patch, whole cell recordings, low glucose depolarized and/or excited a subpopulation of neonatal AMCs; in addition, aglycemia (0 mM glucose) caused inhibition of outward K ϩ current, blunted by the simultaneous activation of glibenclamidesensitive K ATP channels. Some cells were excited by each of the three metabolic stimuli, i.e., aglycemia, hypoxia (PO2 ϳ30 mmHg), and isohydric hypercapnia (10% CO2; pH ϭ 7.4). Using carbon fiber amperometry, aglycemia and hypoglycemia (3 mM glucose) induced robust catecholamine secretion that was sensitive to nickel (50 M and 2 mM) and the L-type Ca 2ϩ channel blocker nifedipine (10 M), suggesting involvement of both T-type and L-type voltage-gated Ca 2ϩ channels. Fura-2 measurements of intracellular Ca 2ϩ ([Ca 2ϩ ]i) revealed that ϳ42% of neonatal AMCs responded to aglycemia with a significant rise in [Ca 2ϩ ]i. Approximately 40% of these cells responded to hypoxia, whereas ϳ25% cells responded to both aglycemia and hypoxia. These data suggest that together with hypoxia and acid hypercapnia, low glucose is another important metabolic stimulus that contributes to the vital asphyxia-induced catecholamine surge from AMCs at birth. aglycemia; hypoglycemia; hypoxia; catecholamines; K ϩ current ALTHOUGH GLUCOSE IS THE PRIMARY metabolic fuel in the fetus, glycogenolysis and gluconeogenesis are absent in utero (27). As a result, fetuses are completely dependent on their mothers for the transplacental facilitated diffusion of glucose. During normal birth, this transport ceases, leading to a decrease in blood glucose (hypoglycemia) in the first few hours of life (26,30,39,51,54). In the newborn, hypoglycemia activates a counterregulatory surge in catecholamines and glucagon and a fall in insulin (11). These hormonal changes stabilize blood glucose by initiating glycogenolysis in liver hepatocytes (21,29). Despite this response, over 2% of newborns experience hypoglycemia and require clinical intervention (13), increasing the risk of brain damage (36). Moreover, premature infants, newborns of diabetic mothers, and neonates small-for-gestational age are at increased risk of hypoglycemia, which is one of the primary causes of increased n...

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“…However, in 2010, Marom R et al reported that the glucose concentrations in infants who were born by vaginal deliveries were higher than in the infants who were born by elective caesarean sections without labour; but no scientific explanation was provided [11].…”

Section: Discussionmentioning

confidence: 99%

A Study on the Correlation between Cord Blood Glucose Level and the Apgar Score

Khan

Saha²

2013

JCDR

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Introduction: The study of the biochemical parameters of cord blood acts as a mirror, which usually reflects the neonatal status. The widely used system for the evaluation of a neonate is the Apgar score. There is no comprehensive published data which has established the association between the cord blood glucose level and the Apgar score. Similarly, there is also no well accepted reference range of the cord blood glucose level. Objectives:The main objectives of the present study was to ascertain any adverse effects of an abnormal cord blood glucose level on the neonatal status and to find out a standard reference level of glucose in cord blood. Methods:The cord blood glucose estimation was done by using the glucose oxidase peroxidase method and the statistical analysis was performed by using the SPSS, version 16 software. Results and Conclusions:In the present study, the cord blood glucose level was found to have no correlation with the Apgar scores which were calculated at both one minute and five minutes after birth. It was also found that for the foetus to be free from any obvious complication, the cord blood glucose level had to be around 87 mg/dl. The fluctuations in the maternal glucose levels are weakly associated with the glucose level in the cord blood.

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Neonatal blood glucose concentrations in caesarean and vaginally delivered term infants

Cited by 27 publications

References 8 publications

Low neonatal blood glucose levels in cesarean-delivered term newborns at Khartoum Hospital, Sudan

Low neonatal blood glucose levels in cesarean-delivered term newborns at Khartoum Hospital, Sudan

Low glucose sensitivity and polymodal chemosensing in neonatal rat adrenomedullary chromaffin cells

A Study on the Correlation between Cord Blood Glucose Level and the Apgar Score

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