High glucose variability is associated with poor neurodevelopmental outcomes in neonatal hypoxic ischemic encephalopathy.

Abstract

BACKGROUND:

In neonatal hypoxic ischemic encephalopathy (HIE), hypo- and hyperglycemia have been associated with poor outcomes. However, glucose variability has not been reported in this population.

OBJECTIVE:

To examine the association between serum glucose variability within the first 24 hours and two-year neurodevelopmental outcomes in neonates cooled for HIE.

STUDY DESIGN:

In this retrospective cohort study, glucose, clinical and demographic data were documented from 23 term newborns treated with whole body therapeutic hypothermia. Severe neurodevelopmental outcomes from planned two-year assessments were defined as the presence of any one of the following: Gross Motor Function Classification System levels 3 to 5, Bayley III Motor Standard Score <70, Bayley III Language Score <70 and Bayley III Cognitive Standard Score <70.

RESULTS:

The neurodevelopmental outcomes from 8 of 23 patients were considered severe, and this group demonstrated a significant increase of mean absolute glucose (MAG) change (-0.28 to -0.03, 95% CI, p = 0.032). There were no significant differences between outcome groups with regards to number of patients with hyperglycemic means, one or multiple hypo- or hyperglycemic measurement(s). There were also no differences between both groups with mean glucose, although mean glucose standard deviation was approaching significance.

CONCLUSIONS:

Poor neurodevelopmental outcomes in whole body cooled HIE neonates are significantly associated with MAG changes. This information may be relevant for prognostication and potential management strategies.

• Authors: N Al Shafouri, M Narvey, G Srinivasan, J Vallance, G Hansen
• Journal: Journal of neonatal-perinatal medicine (J Neonatal Perinatal Med) Vol. 8 Issue 2 Pg. 119-24 ( 2015) ISSN: 1878-4429 [Electronic] Netherlands
• PMID: 26410435 (Publication Type: Journal Article)

Chemical References

• Biomarkers
• Glycated Hemoglobin A
• hemoglobin A1c protein, human

Topics

• Biomarkers (blood)
• Canada (epidemiology)
• Critical Care
• Glycated Hemoglobin (metabolism)
• Glycemic Index
• Humans
• Hyperglycemia (complications, mortality, physiopathology)
• Hypoglycemia (complications, mortality, physiopathology)
• Hypothermia, Induced (methods)
• Hypoxia-Ischemia, Brain (blood, complications, physiopathology, therapy)
• Infant, Newborn
• Monitoring, Physiologic
• Neurodevelopmental Disorders (blood, etiology, physiopathology, prevention & control)
• Retrospective Studies