Early blood glucose profile and neurodevelopmental outcome at two years in neonatal hypoxic-ischaemic encephalopathy.
Affiliation
Neonatal Intensive Care Unit, Cork University Maternity Hospital, Cork, Ireland.Issue Date
2012-01-31T16:43:15ZMeSH
Asphyxia Neonatorum/*blood/complicationsBiological Markers
Birth Weight
Blood Glucose/*analysis
Brain Damage, Chronic/*epidemiology/etiology
Female
Follow-Up Studies
Gestational Age
Humans
Hyperglycemia/congenital/epidemiology
Hypoglycemia/complications/congenital/*epidemiology
Hypothermia, Induced
Hypoxia-Ischemia, Brain/*blood/complications/therapy
Infant, Newborn
Male
Retrospective Studies
Time Factors
Treatment Outcome
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BMC Pediatr. 2011 Feb 4;11:10.Journal
BMC pediatricsDOI
10.1186/1471-2431-11-10PubMed ID
21294901Abstract
BACKGROUND: To examine the blood glucose profile and the relationship between blood glucose levels and neurodevelopmental outcome in term infants with hypoxic-ischaemic encephalopathy. METHODS: Blood glucose values within 72 hours of birth were collected from 52 term infants with hypoxic-ischaemic encephalopathy. Hypoglycaemia [< 46.8 mg/dL (2.6 mmol/L)] and hyperglycaemia [> 150 mg/dL (8.3 mmol/L)] were correlated to neurodevelopmental outcome at 24 months of age. RESULTS: Four fifths of the 468 blood samples were in the normoglycaemic range (392/468:83.8%). Of the remaining 76 samples, 51.3% were in the hypoglycaemic range and (48.7%) were hyperglycaemic. A quarter of the hypoglycaemic samples (28.2%:11/39) and a third of the hyperglycaemic samples (32.4%:12/37) were recorded within the first 30 minutes of life. Mean (SD) blood glucose values did not differ between infants with normal and abnormal outcomes [4.89(2.28) mmol/L and 5.02(2.35) mmol/L, p value = 0.15] respectively. In term infants with hypoxic-ischaemic encephalopathy, early hypoglycaemia (between 0-6 hours of life) was associated with adverse outcome at 24 months of age [OR = 5.8, CI = 1.04-32)]. On multivariate analysis to adjust for grade of HIE this association was not statistically significant. Late hypoglycaemia (6-72 hours of life) was not associated with abnormal outcome [OR = 0.22, CI (0.04-1.14)]. The occurrence of hyperglycaemia was not associated with adverse outcome. CONCLUSION: During the first 72 hours of life, blood glucose profile in infants with hypoxic-ischaemic encephalopathy varies widely despite a management protocol. Early hypoglycaemia (0-6 hours of life) was associated with severe HIE, and thereby; adverse outcome.Language
engISSN
1471-2431 (Electronic)1471-2431 (Linking)
ae974a485f413a2113503eed53cd6c53
10.1186/1471-2431-11-10
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