ESPE Abstracts

Preterm babies born to non-diabetic mothers (INDM) who experience significant hypoglycemia may have postnatal growth abnormalities. This study evaluated the growth pattern from birth to the age of 2 years of 40 INDM who were born at or near term with significant hypoglycemia. Anthropometric measures (z scores) from birth, 2,4.6,12,18 and 2 years were measured in 40 INDM who presented with significant neonatal hypoglycemia (plasma value less than 20-25 mg/dl (1.1-1.4 mmol/l) that required proper therapy (IV glucose bolus followed by IV glucose infusion) for two days or more. Their anthropometric data were compared to standard growth for normal age and sex-matched infants (WHO growth standards). All preterm babies were started on preterm formula until their WAZ became <-1 SD. (average of 6 months)

Results: Their gestational age (GA) at delivery was 36.4 +/-2 weeks. They had Wt. z score (WAZ) = -2.6 +/-1.8, length Z score (LAZ) = -2 +/-2.3 and Wt. for L. Z score (WLZ) =-2.9 +/-1.9. At birth 24/40 (60%) had LAZ >-2, 30/40 (75%) had WAZ > -2 and 29/40 (72.5%) had WLZ >-2. They had a progressive gain in WAZ for the first 18 months (from -2.6 to 0). They had a progressive increase in the LAZ for the first 6 months (from -2.1 to -0.46) that was followed by stable LAZ (normal growth velocity) until 2 years of age. By the age of 12 months 4/40 (10%) had LAZ > -2, 4/40 (10%) had WAZ >-2 and only one had WLZ >-2. One infant had WLZ < 2. By the age of 2 years, none had LAZ or WAZ >-2, and only one infant had WLZ >-2. None of those infants had WLZ < 2 (overweight).

Conclusion: INDMs born preterm or at near term with severe neonatal hypoglycemia had significant short stature and underweight when plotted on WHO growth charts. Feeding preterm formula resulted in a fast postnatal growth pattern with normalization of their linear growth and WAZ during the first year of life. None had overweight at 2 years of age.