Small for gestational age (SGA) infants are known to develop relatively mild transient hyperbilirubinaemia, especially in comparison with premature infants. This may be interpreted as an index of accelerated maturation of particular vital functions. In the present study 12 SGA infants, 12 appropriate for gestational age (AGA) infants, and 12 premature infants had 24 h urine collections under standardized conditions on the third day of life. Urinary excretion of D-glucaric acid and creatinine, which can be increased by drugs (e.g. phenobarbital), were estimated. Haematocrit and bilirubin were determined at the age of 72h. In the 3 groups, the SGA infants had the highest mean haematocrit (SGA = 0.58, AGA = 0.5, Prem = 0.561/1) and the lowest mean bilirubin (SGA = 6.3, AGA = 8.6, Prem = 11.1 mg/dl). Despite a comparatively small urine volume (SGA = 19.6, AGA = 28.3, Prem = 37.3 ml/kg), excretion of D-glucaric acid (SGA = 0.18, AGA = 0.11, Prem = 0.06 mumol/kg) and creatinine (SGA = 101.6, AGA = 79.6, Prem = 80.2 mumol/kg) was significantly higher in the SGA infants. While the results do not provide conclusive evidence, the increased excretion of glucaric acid and creatinine associated with mild transient hyperbilirubinaemia can be considered an indicator of metabolic differences in SGA infants.
Zahlreiche Verfahren zur NH 4 +-Bestimmung im Blut und im Urin sind bisher angegeben und von anderer Seite auch wieder kritisiert worden. Die seit einigen Jahren für die Bestimmung von Ammoniak im Blut bekannte enzymatische Methode von KIRSTEN et al. ([1963], Biochem. Z. 3*7, 312-319), SCHMIDT & SCHWARZ ([1966] The determination of ammonia in the urine of premature and full-term newborns: Comparison of the formol titrationand the en^ymic NH^~ determination Numerous methods for the determination of NH 4 + in blood and urine have been described and subsequently criticized by other workers. The specificity and reproducibility of the enzymatic procedure for the determination of ammonia in blood according to KIRSTEN et al. ([1963], Biochem. Z. 337, 312-319), SCHMIDT & SCHWÄRS ([1966], Klin. Wochenschr. 44, 591-592) and MÜTING et al. ([1970], Deut. Med. Wochenschr. 95, 1390-1396) was tested on urines by comparing it with the very simple formol titration method. The latter method is unsuitable in spite of its high precision, because of the marked influence exerted by amino acids. On the other hand the enzymatic NH 4 + determination is applicable to the urines of premature and full-term newborns particularly because of the relatively low NH 4 + level and the relatively high amino acid concentration. Its precision is equal to the formol titration method, but in addition it is specific and posesses a high sensitivity.
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