alpha-chymotrypsin and Birth-Weight

Specimens of meconium and random stools were collected sequentially from 25 healthy newborn babies over the first 8-14 days of life. The stool chymotrypsin concentrations increased from birth to a maximum at 4 days of age and then fell again over the next four days. The lowest individual stool concentrations either side of the four day peak were both, coincidentally, 120 micrograms/g stool. In a second group of 22 newborn babies suspected of meconium ileus and later confirmed to have cystic fibrosis, faecal chymotrypsin concentrations were all appreciably reduced. In eight babies, also with suspected meconium ileus but with negative sweat tests, chymotrypsin concentrations were within the healthy newborn range. Measuring faecal chymotrypsin concentrations is a reliable procedure for identifying pancreatic exocrine insufficiency in the newborn.

Topics: Birth Weight; Chymotrypsin; Cystic Fibrosis; Feces; Humans; Infant, Newborn; Pigmentation; Reference Values

Pancreatic enzyme activity in low birth weight (LBW) infants during the first postnatal week has been evaluated by analysing the chymotrypsin content of 198 stool specimens from 42 LBW infants with birth weights ranging between 750 and 2570 g. A wide variation in chymotryptic activity yet with a tendency to initially low values with a peak on the third day after birth was found. Small-for-gestational age (SGA) infants had significantly lower values than appropriate-for-gestational age (AGA) infants. This is considered due to intra-uterine malnutrition with secondary pancreatic dysfunction in SGA infants. In screening program for cystic fibrosis or other defects of exocrine pancreatic activity, low stool chymotrypsin values cannot be considered pathological until after the fourth day of life.

Topics: Age Factors; Birth Weight; Chymotrypsin; Feces; Gestational Age; Humans; Infant Nutritional Physiological Phenomena; Infant, Newborn; Infant, Premature; Milk, Human; Parenteral Nutrition

Topics: Birth Weight; Blood Coagulation Disorders; Chymotrypsin; Female; Gestational Age; Humans; Infant, Newborn; Infant, Newborn, Diseases; Obstetric Labor Complications; Pregnancy; Trypsin Inhibitors; Umbilical Veins