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101 POSTNATAL ENDOGENOUS GLUCOSE PRODUCTION RATE (EGPR) RELATED TO SEVERITY OF INTRA-UTERINE GROWTH RETARDATION (IUGR)

The increased risk to hypoglycaemia in IUGR newborn infants is thought to be due to a limited EGPR. One might speculate that EGPR will be more reduced in infants with more severe IUGR. We measured EGPR in 16 IUGR infants with the prime dose-constant rate infusion technique using 6,6Da glucose. Gestational age ranged from 30 to 40 weeks (35±3 wk, mean±SD), birthweight ranged from 0.9 to 2.2 kg (1.7±0.4 kg). The infants were studied at a mean postnatal age of 9 hours. The infants received a low dose glucose infusion (mean 3.5 mg/kg.min−1).Results: Despite the low dose glucose infusion EGPR ranged from 0.4 to 3.2 mg/kg.min−1. EGPR increased significantly with increasing gestational age (r=0.55, P=0.03) and birthweight (r=0.55, P=0.03). If the degree of IUGR was expressed in Standard Deviation Score (SDS) and Brain/Body Ratio (BB-ratio) we found no significant correlation between EGPR and SDS. However, with increasing BB-ratio, EGPR was significantly (r=-0.54, P=0.03) lower.Conclusion: The lowest EGPR was measured in infants of shortest gestation and with the lowest birhtweight. IUGR infants with an asymmetrical growth retardation, who thus have a high BB-ratio, seem to have an increased risk to develop hypoglycaemia, since they have the lowest EGPR.