EARLY DETECTION OF METABOLIC ABNORMALITIES IN PRETERM INFANTS IMPAIRED BY DISORDERS OF BLOOD-GLUCOSE CONCENTRATIONS

We recently reported (Acta Paediatr Scand 1992;8: 580-4) three preterm infants with severe respiratory distress syndrome and abnormal glucos e profiles for the first 5 days of life who subsequently died in infan cy; only at autopsy were they shown to have abnormal glucose-6-phospha tase activity. We have therefore studied retrospectively in a matched cohort of 109 infants the blood glucose profiles correlated with the s everity of respiratory distress syndrome (expressed as the fraction of inspired oxygen, FiO(2)): group A, mild, FiO(2) <0.25; group B, moder ate, FiO(2) 0.26-0.50; group C, severe, FiO(2) >0.51. All groups had a similar frequency of low blood glucose values (15% less than or equal to 2.2 mmol/L; 29% less than or equal to 2.6 mmol/L), but high blood glucose values and greater variability in glucose values were more com mon in groups B and C despite lower caloric intakes (A, 4.3%; B, 9.3%; C, 9.6% greater than or equal to 7 mmol/L). We conclude that the earl y blood glucose patterns in those three previously described preterm i nfants with abnormal hepatic glucose-6-phosphatase activity at autopsy cannot be viewed as abnormal when considered against a matched cohort of infants. Preterm infants at risk of genetic or developmental delay s in blood glucose homeostasis should be reassessed after recovery fro m their acute illnesses.