Because of their physiological and anatomical immaturity, premature infants are prone to disorders of glucose metabolism. In the ifrst week after birth, infants have the greater risk of abnormal glucose metabolism. Compared with term infants, the glucose/insulin homeostasis of preterm infants is very different. This article reviewed the characteristics of glycometabolism in premature infant and the methods of glucose test.

Objectives To analyze the impact of glucose-insulin metabolism during pregnancy onβ-cell function in premature infant, and to explore biomarkers for monitoringβ-cell function in preterm infant. Methods Eighty-two premature infants admitted to NICU from March to December 2012 were divided into 2 groups, a group with abnormal maternal glucose metabolism during pregnancy (35 cases) and another group with normal maternal glucose metabolism during pregnancy group (47 cases). Fasting blood glucose, insulin, C-peptide and proinsulin at 1 hour after birth and 7 days postpartum were measured respectively, and relevant indices ofβ-cell function were compared in premature infants. Results Maternal pre-pregnancy and prenatal body mass index, weight and head circumference of preterm infants at birth were signiifcantly different between two groups (P<0.05) except for maternal weight gain in pregnancy (P>0.05). The differences in levels of proinsulin at birth, C-peptide and proinsulin at postnatal day 7 were signiifcantly different between the two groups (P<0.05). There was no signiifcant diffe-rence in insulin resistance, fastingβcell function index and insulin sensitivity index between two groups (P>0.05). Conclusions Abnormal maternal glucose metabolism in pregnancy has no effect on early pancreatic islet function in premature infant, how-ever, proinsulin secretion has been affected.

Objective:To study the correlation between umbilical artery blood gas (UABG) and Apgar score of neonates and the risk factors of low base excess (BE) in UABG.Methods:From March 2017 to September 2020, newborns without congenital malformation born in three hospitals were prospectively enrolled and received UABG analysis. According to their Apgar score, the infants were assigned into low Apgar score group and normal Apgar score group. According to BE of UABG, they were assigned into BE<-12 mmol/L group and BE≥-12 mmol/L group. The UABG indexes including abnormal pH and BE between the low Apgar score group and the normal Apgar score group were compared. The risk factors of low BE in UABG were analyzed.Results:A total of 1 351 qualified samples were included including 208 cases in low Apgar score group and 1 143 cases in normal Apgar score group. 115 cases were in BE <-12 mmol/L group and 1 236 cases in BE ≥-12 mmol/L group. The incidences of abnormal pH and BE values in the low Apgar score group were higher than the normal Apgar score group [50.0% (104/208) vs. 13.8% (158/1 143), 34.6% (72/208) vs. 3.8% (43/1 143)]. The pH and BE values of UABG were positively correlated with 1 min Apgar score ( r=0.402, 0.398, P<0.001). Multivariate logistic regression analysis indicated that the risk factors for BE<-12 mmol/L were Ⅲ° contaminated amniotic fluid ( OR= 3.155, 95% CI 1.972~5.025, P<0.001) and placental abruption ( OR = 3.968, 95% CI 1.992~7.874, P <0.001). Conclusions:The pH and BE values of neonatal UABG are positively correlated with 1 min Apgar score. Ⅲ° contaminated amniotic fluid and placental abruption are risk factors of low BE in UABG.