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Metabolic effects of obstetric regional analgesia and of asphyxia in the newborn infant during the first two hours after birth. II. Arterial plasma concentrations of glycerol, free fatty acids and beta-hydroxybutyrate.

Effects of obstetric regional analgesia and of asphyxia on the arterial blood concentrations of the lipid metabolites: glycerol, free fatty acids and beta-hydroxybutyrate were investigated in 85 newborn infants divided into a control group, an asphyxia group, a continuous epidural, an intermittent epidural and a paracervical + pudendal block group: lidocaine was the drug used in the analgesia groups. The postnatal changes in lipid metabolites followed three different patterns. After marked increases in glycerol and free fatty acids a steady level was reached after one hour in the control group and not before two hours in the regional analgesia groups. In the asphyxia group, however, a steady level was found already 10 min after birth. Between 30 and 120 min after birth the beta-hydroxybutyrate concentration increased in the control group, decreased in the asphyxia group and did not change in the three regional analgesia groups. The different patterns of lipid metabolites may indicate differences in sympathetic tone and/or in hormonal influences after birth.

3-Hydroxybutyric Acid↗

Metabolic events in infants of diabetic mothers during first 24 hours after birth. II. Changes in plasma lipids.

Changes in plasma glycerol (FG), free fatty acids (FFA) and triglyceride (TG) were studied in 24 normo- and 8-hypoglycemic infants of diabetic mothers (IDM). In both groups a normal rise in plasma FG 2 hours after birth was found indicating unimpaired lipolysis. The rise in plasma FFA, however, was only about 50% of normal in normoglycemic IDM and about 25% of normal in hypoglycemic IDM. The rise in plasma TG was normal in normoglycemic and about 70% of normal in hypoglycemic IDM. The 2 hour rise in plasma FFA correlated with the 2 hour concentration of insulin and glucose, whereas the rise in plasma FG and TG did not. Maternal plasma FFA correlated with fetal FFA retention (umbilical vein minus artery (V-A) FFA concentrations). No correlations were found between maternal plasma FFA values and birth-weights nor between umbilical V-A FFA concentrations and birth-weights.

Adult↗

Assessment of thermoregulatory and postprandial thermogenesis over the first 24 hours after birth in pigs.

Heat production was continuously measured from birth to 24 h after birth in pigs tube-fed 14 g kg-1 of colostrum or water (sham-fed animals) at hourly intervals, and maintained at thermoneutrality (34 degrees C) or in moderate cold (24 degrees C). Results indicate that colostrum was necessary to initiate and sustain the postnatal rise in metabolic rate observed at 34 degrees C. It provided about 75% of the energy required for heat production at 24 degrees C. Heat production was increased by 74% in the cold and decreased by 30% during starvation. In both cases, maintenance of the energy balance was achieved with a compensatory drop in body temperature. At 34 degrees C, variations in postmeal heat production represented 12% of the total 24 h energy expenditure and were almost equally due to the thermogenic effect of colostrum and to confounding factors, including physical activity. In the cold, calculated postmeal thermogenesis accounted only for 3% of 24 h energy expenditure and for 9% of the extra heat produced in the cold. Our results highlight the main role of colostral energy in the energy metabolism of the newborn pig in a typical birth environment (24 degrees C) and in thermoneutral conditions (34 degrees C). Thermoneutral postmeal thermogenesis is low and its contribution to the extra heat produced in the cold very limited.

Animals↗

Evidence that hepatic mitochondrial mass decreases during the first sixteen hours following birth in starved newborn rats.

Fatty acid oxidation increases in newborn rats between 0 and 16 h after birth. We have tested the hypothesis that such a rise might be due to an increase in hepatic mitochondrial mass. The ratio total activity/specific activity for cytochrome c oxidase and citrate synthase was used as an index that reflected the changes in mitochondrial mass. This ratio was decreased by about 25% 16 h after delivery, indicating that hepatic mitochondrial mass was lower 16 h after birth than at birth in starved rats. We conclude that changes in the mitochondrial mass are not responsible for the increase in liver capacity to oxidize fatty acids.

Animals↗

Hypoxanthine concentration in plasma during the first two hours after birth in normal and asphyxiated infants.

The measurement of arterial plasma concentration of hypoxanthine in 16 healthy newborn infants showed a prominent increase after birth compared with the umbilical cord levels. Peak values were found 10-20 min after birth with a maximal value of 11.9 mumole/liter in the normal newborns. In five asphyxiated infants the postnatal pattern of hypoxanthine was the same as for normal infants but the increase was even more prominent. A mean peak value of 33.7 mumole/liter was noted in the asphyxiated infants. Our results indicate that the hypoxanthine concentration is influenced not only by the degree of hypoxia, but also by the peripheral circulation and the time interval between the hypoxic event and the blood sampling. It is concluded that hypoxanthine assay may be of clinical value for the detection od past hypoxia as a semiquantitative test.

Asphyxia Neonatorum↗

Transient evoked otoacoustic emissions in newborns in the first 48 hours after birth.

Newborns are often discharged from hospital at the age of about 48 hours. At this age, transient evoked otoacoustic emissions (TEOAEs) are not necessarily recordable in all healthy newborns. In order to determine the factors which would enable the successful recording of TEOAEs before discharge to facilitate screening for hearing, 65 fullterm newborns under 48 hours of age were tested, the youngest being 10 hours old. The ears of those neonates in whom TEOAEs could not be obtained (N = 7 neonates bilaterally, 6 unilaterally) were examined otoscopically, cleaned of vernix and retested for TEOAEs. We were thus able to record in at least one ear in all neonates tested, if the ears were clean, if they were asleep and if the testing room was quiet.

Acoustic Stimulation↗

On estimating fertility using first and second order births.

"An attempt has been made to present two regression equations for estimating total fertility rate from the birth order data. While one of the equations has been derived from the longitudinal data of Malaysia another has been obtained from cross sectional data on Mother's total fertility rate...and births of orders one and two. These equations are used to estimate the [total fertility rate] for the districts of [Uttar Pradesh, India,] which are quite close to the estimates obtained by using other methods."

Asia↗