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Glucose Regulation When Premature Infants Grow Up

Very low birth weight was associated with impaired glucose regulation in adulthood.

Full-term infants who are small for gestational age are known to have impaired glucose regulation as adults, but few data are available about glucose regulation in premature infants when they reach adulthood. Investigators in Helsinki compared glucose regulation in 163 adults (age range, 18–27 years) who were premature at birth (mean birth weight, 1120 g; mean gestational age, 29 weeks) and 169 adults who were matched for age and gender and were full term at birth.

Based on a standard 75-g oral glucose challenge, virtually all measures of glucose regulation were significantly impaired in the premature group. For example, the premature group, compared with the control group, had significantly higher mean concentrations of both 2-hour glucose (96 vs. 91 mg/dL) and insulin (34.1 vs. 25.6 mU/L). These results did not change after adjustment for body composition and BMI in adulthood. In addition, results were similar between premature infants whose weights were and were not considered appropriate for gestational age.

Comment: As noted by an editorialist, neonates who weighed 1000 g in the 1960s had a 95% chance of dying, while today they have a 95% chance of surviving. During the past decade, our focus has shifted from survival to understanding the neurocognitive, and more recently, metabolic consequences of prematurity. Whether these data represent a response to the stress of premature birth or the lack of complete in utero organogenesis is unknown. Further, the longer-term consequences of these observations have yet to be detailed.

— Howard Bauchner, MD

Published in Journal Watch Pediatrics and Adolescent Medicine May 16, 2007

Citation(s):

Hovi P et al. Glucose regulation in young adults with very low birth weight. N Engl J Med 2007 May 17; 356:2053-63.

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• Medline abstract (Free)

Ingelfinger JR. Prematurity and the legacy of intrauterine stress. N Engl J Med 2007 May 17; 356:2093-5.

• Original article (Subscription may be required)
• Medline abstract (Free)