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Am J Perinatol 2015; 32(09): 865-872
DOI: 10.1055/s-0034-1543948
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Birth Weight, Insulin Resistance, and Blood Pressure in Late Preterm Infants

Hany Aly
1   Department of Neonatology, The George Washington University and Children's National Medical Center, Washington, District of Columbia
,
Reem M. Soliman
2   Department of Pediatrics, Cairo University, Cairo, Egypt
,
Mohamed El-Dib
1   Department of Neonatology, The George Washington University and Children's National Medical Center, Washington, District of Columbia
,
Enas M. Fawzy
3   National Nutrition Institute, Cairo, Egypt
,
Nora E. Badawi
2   Department of Pediatrics, Cairo University, Cairo, Egypt
,
Walaa A. Rabie
4   Department of Clinical and Chemical Pathology, Cairo University, Cairo, Egypt
,
Ayman A. Elbadawi
2   Department of Pediatrics, Cairo University, Cairo, Egypt
› Author Affiliations
Further Information

Publication History

22 May 2014

18 November 2014

Publication Date:
16 January 2015 (online)

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Abstract

Objectives This study aims to compare insulin sensitivity, lipid profile, and blood pressure in late preterm infants born at appropriate for gestational age (AGA) and small for gestational age (SGA).

Study Design We conducted a prospective, observational study on AGA and SGA late preterm infants. Blood pressure, fasting blood glucose, insulin, insulin-like growth factor 1 (IGF-1), insulin resistance, and lipid profile were measured on the 1st day and in the 2nd week of life.

Results Overall 81 infants (41 AGA and 40 SGA) were included in the study. At the time of enrollment, there was no difference in blood pressure, insulin resistance, and lipid profile. At follow-up SGA patients had significantly decreased diastolic blood pressure (48 ± 11 mm Hg vs. 42 ± 11 mm Hg, p = 0.04), and decreased IGF-1 (139 ng/mL [119–153] vs. 124 ng/mL [115–138], p = 0.05). No linear association was found between the insulin resistance and either birth weight percentile, day of life, or average 1st week daily caloric intake.

Conclusion As compared with AGA, SGA late preterm infants had lower diastolic blood pressure and lower IGF-1 during the 2nd week of life, but similar insulin resistance and lipid profile. We speculate that although metabolic derangements in SGA infants could have occurred at a much earlier age in fetal life, their manifestations may not be present in the immediate postnatal life.

Keywords

glucose - SGA - metabolic syndrome - premature - nutrition