ESPE2022 Poster Category 1 Fetal, Neonatal Endocrinology and Metabolism (30 abstracts)
Postnatal growth pattern in (n=51) infants of non-diabetic mothers (INDM) who were born preterm or near term and had significant neonatal hypoglycemia
Nada Alaaraj , Ashraf Soliman , Shayma Ahmed , Noor Hamed , Fawzia Alyafei , Hamdy Ali , Maya Itani , Fatima Al-Naimi , Mona Shaat & Doaa Al-Yousef
Hamad General Hospital, Doha, Qatar
Prematurity is a risk factor for significant hypoglycemia even in infants born to non-diabetic mothers (INDM) which could lead to postnatal growth abnormalities. This study evaluated the growth pattern from birth until the age of 2 years of 51 INDM who were born preterm or near term and admitted with significant hypoglycemia. Anthropometric measures (z scores) from birth, 2,4,6,12,18 and 2 years were measured in 51 INDM who admitted with 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: At delivery, gestational age (GA) was 36.7 +/-2.44 weeks. They had Weight Z score (WAZ) = -2.21 +/-2.02, length Z score (LAZ) = -1.9 +/-2.4 and Weight for length Z score (WLZ) =-2.47 +/-2.07. At birth 28/51 (55%) had LAZ <-2, 35/51 (69%) had WAZ < -2 and 32/51 (63%) had WLZ <-2. They had a progressive gain in WAZ for the first 18 months (from -2.21 to 0.05). They had a progressive increase in the LAZ for the first 12 months (from -1.9 to -0.5) followed by stable LAZ (normal growth velocity) until 2 years of age. By the age of 12 months 6/51 (12%) had LAZ < -2, 4/51 (8%) had WAZ <-2 and only one had WLZ <-2. None of the infants had WLZ > 2. By the age of 2, none had LAZ, one infant had WAZ <-2, and only one infant had WLZ <-2. None of those infants had WLZ > 2 (overweight).
| Age (mon) | Birth | 2 | 4 | 6 | 12 | 18 | 24 |
| WAZ | -2.21 | -1.82 | -1.21 | -0.9 | -0.12 | 0.05 | -0.23 |
| WLZ | -2.47 | -0.05 | -0.17 | -0.19 | 0.14 | 0.28 | -0.16 |
| LAZ | -1.9 | -2.02 | -1.47 | -1.13 | -0.49 | -0.39 | -0.46 |
Conclusion: Preterm or near-term babies born for non-diabetic mothers with severe neonatal hypoglycemia had significant growth impairment when plotted on WHO growth charts. The use of the preterm formula results in a fast normalization of their growth in the first year of life with no apparent risk of being overweight at 2 years of age.
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