Abstract
In order to study the pathogenesis of hypocalcemia in IDM, determinations of serum levels of Ca, P, Mg, iPTH and iCT were performed in 15 IDM (gestational age : 36.7 ± 1.3 weeks ; birth weight : 3755 ± 617 g) at 2, 24, 48 h and 5 days. Infants were infused with glucose and fed with human milk. Serum Ca (mg/dl, mean ± SD) decreased from 2 (8.6 ± 0.6) to 24 h (7.1 ± 1.2, p < 0.001) and remained low at 48 h and 5 days (7.5 ± 0.5). Serum Mg (mg/dl ; mean ± SD) decreased from 2 h (1.8 ± 0.2) to 24 h (1.6 ± 0.2, p <0.02) and returned to normal levels at 5 days. There was no significant change in serum P (6.3 ± 1.7 and 7.0 ± 1.2 mg/dl at 2 h and 5 days). Serum iPTH - undectable (<25 μlEq/ml) in 6 IDM and ranging from 27 to 160 μlEq/ml in 7 at 2 h (normal range in children : < 100) - showed a sustained increase until 5 days (184 ± 119 μlEq/ml, p<0.01). Serum iCT was undectable (<150 mg/ml) in 9 IDM and ranged from 150 to 180 pg/ml in 4 at 2 h ; it showed a marked increase at 24 h (536 ± 208 pg/ml, p<0.001) and by 5 days returned to mostly undectable values. Our findings indicate that hypocalcemia of IDM takes place during the first day of life ; in most IDM there is evidence for parathyroid responsiveness ; hypercalcitoninemia is present during the first 48 h. These data suggest that in IDM 1) Ca metabolism is similar to that of other premature infants and 2) hypocalcemia is mostly the consequence of the abrupt interruption of the large maternal Ca supply.
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David, L., Salle, B., Varenne, P. et al. Evolution of serum calcium (Ca), phosphorus (P), magnesium (Mg), immunoreactive parathyroid hormone (iPTH) and calcitonin (iCT) levels in infants of diabetic mother (IDM) from 2 hours to 5 days of life. Pediatr Res 14, 1419 (1980). https://doi.org/10.1203/00006450-198012000-00066
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DOI: https://doi.org/10.1203/00006450-198012000-00066