Neurodevelopmental Outcome of Asymptomatic Hypoglycemia Compared With Symptomatic Hypoglycemia and Euglycemia in High-Risk Neonates

摘要

Abstract Aims We assessed the neurodevelopmental outcome at one year of age of children with asymptomatic neonatal hypoglycemia and compared their outcome with that of symptomatic hypoglycemic and euglycemic neonates. Method Seventy two hypoglycemic (plasma glucose less than 50?mg/dL)?neonates, both symptomatic (n?=?27)?and asymptomatic (n?=?45), and 70 weight-?and gestation-matched euglycemic neonates of gestational age?greater than 32?weeks?were?enrolled during the first?week of life then assessed for neurodevelopmental outcome at corrected age?six and 12?months (n?=?67 and 62 in hypoglycemia group and 63 and 54 in euglycemia group, with the rest lost to follow-up, and death?=?1). Results At one?year, 8% (five?of 62,?four?in?symptomatic and one in asymptomatic group) of hypoglycemic neonates developed cerebral palsy. Mean motor?and?mental development quotients were significantly lower at corrected ages six and 12?months in any hypoglycemia ( P ??0.001) and if blood glucose was less than 40?mg/dL ( P ??0.001) when compared with euglycemia. Symptomatic infants had lower motor development quotient ( P ?=?0.004 and 0.003) and mental development quotient ( P ?=?0.001 and 0.001) at corrected ages six and 12?months than asymptomatic infants, and asymptomatic infants had lower motor development quotient ( P ?≤?0.001 and 0.004) and mental development quotient ( P ?=?0.001 and 0.004) than the?euglycemic group at corrected ages six and 12?months, respectively. Blood glucose of less than 40?mg/dL?had high sensitivity (83% for motor development quotient and 81% for mental development quotient) for?development quotient scores of less than 85. Conclusion Hypoglycemia, both symptomatic and asymptomatic, leads to adverse neurodevelopmental outcome when compared with euglycemia, although it was worse in the?symptomatic group and at blood glucose?less than?40?mg/dL.