Neonatal Nurse Practitioner Practice Exam

Intrauterine growth-restricted infants are at risk for decreased glycogen stores because of?

1. Altered regulation of insulin secretion in pancreatic beta cells

2. Hypoxia-induced increased catecholamine secretions

3. Inhibition of gluconeogenesis secondary to high insulin concentrations

4. Insufficient placental blood flow

The correct answer is: Hypoxia-induced increased catecholamine secretions

Intrauterine growth-restricted (IUGR) infants are indeed at risk for decreased glycogen stores, and the correct rationale for this is related to hypoxia-induced increased catecholamine secretions. In IUGR, the compromised intrauterine environment often leads to inadequate oxygen supply, or hypoxia. The body responds to this low oxygen situation by releasing catecholamines like epinephrine and norepinephrine, which can lead to increased metabolic demands and alterations in metabolic processes, including glucose metabolism. This catecholamine surge can cause several physiological changes, including the mobilization of glycogen stores to meet immediate energy needs. However, chronic exposure to these heightened catecholamine levels can also have detrimental effects, resulting in inadequate glycogen accumulation in the liver and other tissues. As a consequence, IUGR infants tend to have lower glycogen reserves at birth, making them more vulnerable to hypoglycemia and other metabolic complications. Understanding the interplay between hypoxia, catecholamine response, and glycogen metabolism is crucial for recognizing the pathophysiology behind the decreased glycogen stores observed in IUGR infants.