Short and long term outcome of neonatal hyperglycemia in very preterm infants: a retrospective follow-up study
Open Access
- 20 July 2010
- journal article
- Published by Springer Science and Business Media LLC in BMC Pediatrics
- Vol. 10 (1), 52
- https://doi.org/10.1186/1471-2431-10-52
Abstract
Background Hyperglycemia in premature infants is associated with increased morbidity and mortality, but data on long-term outcome are limited. We investigated the effects of neonatal hyperglycemia (blood glucose ≥ 10 mmol/l, treated with insulin for ≥ 12 hours) on growth and neurobehavioral outcome at 2 years of age. Methods Retrospective follow-up study at 2 years of age among 859 infants ≤32 weeks of gestation admitted to a tertiary neonatal center between January 2002 and December 2006. Thirty-three survivors treated with insulin for hyperglycemia and 63 matched controls without hyperglycemia were evaluated at a corrected age of 2 years. Outcome measures consisted of growth (weight, length, and head circumference) and neurological and behavioural development. Results 66/859 (8%) infants ≤ 32 weeks of gestation developed hyperglycemia. Mortality during admission was 27/66 (41%) in the hyperglycemia group versus 62/793 (8%) in those without hyperglycemia (p < 0.001). Mortality was higher in infants with hyperglycemia with a birth weight ≤1,000 gram (p = 0.005) and/or gestational age of 24-28 weeks (p = 0.009) than in control infants without hyperglycemia. Sepsis was more prominent in infants with hyperglycemia and a birth weight of >1,000 gram (p = 0.002) and/or gestational age of 29-32 weeks (p = 0.009) than in control infants without hyperglycemia. Growth at 2 years of age was similar, but neurological and behavioural development was more frequently abnormal among those with neonatal hyperglycemia (p = 0.036 and 0.021 respectively). Conclusions Mortality was higher in very preterm infants with hyperglycemia treated with insulin during the neonatal period. At 2 years of age survivors showed normal growth, but a higher incidence of neurological and behavioural problems. Better strategies to manage hyperglycemia may improve outcome of very preterm infants.Keywords
This publication has 24 references indexed in Scilit:
- Continuous Glucose Monitoring in Infants of Very Low Birth WeightNeonatology, 2008
- Survey of the management of neonatal hyperglycaemia in AustralasiaJournal of Paediatrics and Child Health, 2007
- Hyperglycemia Is a Risk Factor for Early Death and Morbidity in Extremely Low Birth-Weight InfantsPEDIATRICS, 2006
- Relationship between Hyperglycemia and Retinopathy of Prematurity in Very Low Birth Weight InfantsNeonatology, 2006
- Continuous Insulin Infusion in Hyperglycaemic Extremely-Low- Birth-Weight NeonatesNeonatology, 2005
- Intensive Insulin Therapy in Critically Ill PatientsThe New England Journal of Medicine, 2001
- A controlled trial of insulin infusion and parenteral nutrition in extremely low birth weight infants with glucose intoleranceThe Journal of Pediatrics, 1991
- Insulin infusion with parenteral nutrition in extremely low birth weight infants with hyperglycemiaThe Journal of Pediatrics, 1989
- Incidence and evolution of subependymal and intraventricular hemorrhage: A study of infants with birth weights less than 1,500 gmThe Journal of Pediatrics, 1978
- Acute pulmonary X-ray changes in hyaline membrane disease treated with artificial ventilation and positive end-expiratory pressure (PEP)Pediatric Radiology, 1973