Blood glucose concentration in the perinatal period.

Low blood sugar concentrations are common in infants, and concentrations which in the adult would be considered pathologically low may be physiological in the newborn in whom hypoglycaemia is not necessarily associated with symptoms (Ketteringham and Austin, 1938; McKittrick, 1940; Hanley and Horn, 1943; Norval, Kennedy, and Berkson, 1949; Wachter, 1949; Pedersen, 1952; Desmond, 1953; Lowrey, Graham, and Tsao, 1954; Hartmann, 1955; Haworth and Ford, 1960; Kaye, Davidson, Williams, Kumagai, and Picou, 1961; Melichar, Novak, Hahn, and Koldovsky, 1964; Neligan, 1964a; Stur, 1964; Hjelm and Sjolin, 1965). Symptomatic hypoglycaemia has been described in infants with lesions which might be expected to lower the blood sugar concentration (Mason and Andersen, 1941; Sherman, 1947), and Hartmann and Jaudon (1937) attributed to hypoglycaemia certain symptoms in infants of diabetic mothers, though Pedersen (1952), Lowrey et al. (1954), and Farquhar (1956) found equally low blood sugar concentrations in patients with no symptoms. As early as 1934, Holman and Mathieu suggested that the blood sugar might fall to dangerously low concentration in infants of toxaemic mothers, but it is only since Cornblath, Odell, and Levin (1959) revived interest in such cases that symptomatic hypoglycaemia in the neonatal period has been accepted as a definite and not uncommon entity. The association between foetal malnutrition and neonatal hypoglycaemia has been described by Brown and Wallis (1963) and by Neligan, Robson, and Watson (1963). Cornblath now feels that poor foetal growth was the most important aetiological factor in the cases of hypoglycaemia which he and his colleagues originally attributed to maternal toxaemia (Cornblath et al., 1959; Neligan, 1964b). Even in asymptomatic babies with the foetal mal-