Koh Daisy, Hume Robert, Eisenhofer Graeme, Ogston Simon, Watson Jennifer, Williams Fiona
J Perinat Med. 2015 May;43(3):339-46. doi: 10.1515/jpm-2014-0067.
To assess factors contributing to cord venous glucose homeostasis in term infants delivered by elective cesarean section.
Observational study of women-infant pairs at delivery. Biochemical and clinical data were collected about factors which might affect the levels of glucose, lactate, norepinephrine, epinephrine, cortisol, human growth hormone, glucagon, and insulin.
In the context of this data-set, three models explained a substantial amount regarding the variation: 79% of the variation in cord glucose levels is explained by levels of maternal glucose, cord venous pH, and cord lactate; 77% of the variation of cord lactate is explained by levels of cord venous pH, valine, maternal lactate and glucose, and cord norepinephrine; and 71% of the variation in cord norepinephrine is explained by levels of cord venous pO2, maternal lactate, cord insulin, cord GABA (gamma-aminobutyric acid), cord lactate, cord epinephrine, cord norepinephrine sulfate, and cord valine.
Term infants delivered by cesarean section are relatively hyperinsulinemic (insulin:glucose ratio of 2.4) and glucose levels are strongly associated with maternal glucose levels, cord pO2, and lactate levels. There were no associations with levels of cord glucose and levels of cortisol, epinephrine and lactate, which have been shown to be important contributors to postnatal glucose homeostasis in some infant groups.
评估择期剖宫产分娩的足月儿脐静脉葡萄糖稳态的影响因素。
对分娩时的母婴对进行观察性研究。收集了关于可能影响葡萄糖、乳酸、去甲肾上腺素、肾上腺素、皮质醇、人生长激素、胰高血糖素和胰岛素水平的因素的生化和临床数据。
在该数据集的背景下，三个模型对变异的解释程度较高：脐血葡萄糖水平变异的79%可由母体葡萄糖水平、脐静脉pH值和脐血乳酸水平解释；脐血乳酸变异的77%可由脐静脉pH值、缬氨酸、母体乳酸和葡萄糖水平以及脐血去甲肾上腺素水平解释；脐血去甲肾上腺素变异的71%可由脐静脉pO2、母体乳酸、脐血胰岛素、脐血GABA（γ-氨基丁酸）、脐血乳酸、脐血肾上腺素、脐血硫酸去甲肾上腺素和脐血缬氨酸水平解释。
剖宫产分娩的足月儿相对高胰岛素血症（胰岛素：葡萄糖比值为2.4），葡萄糖水平与母体葡萄糖水平、脐血pO2和乳酸水平密切相关。脐血葡萄糖水平与皮质醇、肾上腺素和乳酸水平无关联，而在一些婴儿组中，这些已被证明是出生后葡萄糖稳态的重要影响因素。
