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Growth and Development Unit, University of Oxford, University Field Laboratory, Wytham, Oxford, OX2 8QJ, United Kingdom
Increased epinephrine (Epi) and norepinephrine (NE)
production plays an important role in fetal adaptation to reduced
oxygen and/or nutrient availability, inhibiting insulin secretion and slowing growth to support more essential processes. To assess the
importance of hypoinsulinemia for the efficacy of catecholamines, normoinsulinemia was restored by intravenous insulin infusion (0.18 mU · kg
1 · min
1)
during prolonged infusion of either Epi (0.25-0.35
µg · kg
1 · min
1
for 12 days, n = 7) or NE (0.5-0.7
µg · kg
1 · min
1
for 7 days, n = 6) into normoxemic fetuses in twin-pregnant
ewes, from 125-127 days of gestation. Insulin infusion for 8 days
during Epi infusion or for 4 days during NE infusion decreased arterial blood pressure, O2 content, and plasma glucose, but
increased heart rate significantly (all P <0.05), despite
continuation of Epi or NE infusion. Cessation of insulin infusion
reversed these changes. Estimated growth of fetuses infused with
insulin during Epi or NE infusion (55 ± 13.9 and 83 ± 15.2 g/day)
did not differ significantly from that of untreated controls (72 ± 15.4 g/day, n = 6). Growth of selected muscles and hindlimb
bones was not altered either. Restoration of normoinsulinemia evidently
counteracts the redistribution of metabolic activity and decreased
anabolism brought about by Epi or NE in the fetus. Inhibition of
insulin secretion by Epi and NE, therefore, appears essential for the efficacy of catecholamine action in the fetus.
epinephrine; norepinephrine; insulin; blood pressure; heart rate; fetal growth
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