Neonatal hyperglycaemia is associated with worse neurodevelopmental outcomes in extremely preterm infants
| Autor: | Itay Zamir, Ingrid Hansen-Pupp, Fredrik Serenius, Fredrik Ahlsson, Magnus Domellöf, E Stoltz Sjöström |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Blood Glucose
medicine.medical_specialty Pediatrics Neurology Developmental Disabilities medicine.medical_treatment Infant Premature Diseases neonatology endocrinology Intellectual Disability medicine Neonatal hyperglycaemia Humans Hypoglycemic Agents Insulin Neonatology Child Original Research Wechsler Intelligence Scale for Children Neurologic Examination Intelligence quotient business.industry Extremely preterm neurology Infant Newborn Wechsler Scales Obstetrics and Gynecology Pediatrik General Medicine Prognosis Hyperglycemia Infant Extremely Premature Pediatrics Perinatology and Child Health Observational study business Follow-Up Studies |
| Zdroj: | Archives of Disease in Childhood. Fetal and Neonatal Edition |
| Popis: | ObjectiveTo assess the associations between neonatal hyperglycaemia and insulin treatment, versus long-term neurodevelopmental outcomes in children born extremely preterm.Design and settingObservational national cohort study (Extremely Preterm Infants in Sweden Study) using prospectively and retrospectively collected data. Neurodevelopmental assessment was performed at 6.5 years of age.Patients533 infants born Outcome measuresNeurodevelopmental disability (NDD), survival without moderate to severe NDD, Wechsler Intelligence Scale for Children IV Full scale intelligence quotient (WISC-IV FSIQ) and Movement Assessment Battery for Children 2 (MABC-2) total score.ResultsDuration of neonatal hyperglycaemia >8 mmol/L was associated with WISC-IV scores—for each day with hyperglycaemia there was a decrease of 0.33 points (95% CI 0.03 to 0.62) in FSIQ. Neonatal hyperglycaemia >8 mmol/L occurring on 3 consecutive days was associated with lower MABC-2 scores (adjusted mean difference: −4.90; 95% CI −8.90 to −0.89). For each day with hyperglycaemia >8 mmol/L, there was a decrease of 0.55 points (95% CI 0.17 to 0.93) in MABC-2 total score. Insulin treatment was not associated with any of the outcome measures.ConclusionNeonatal hyperglycaemia >8 mmol/L was associated with lower intelligence scores and worse motor outcomes at 6.5 years of age. Insulin treatment was not associated with either worsened or improved neurodevelopmental outcomes. Randomised controlled trials are needed to clarify the role of insulin in treating hyperglycaemia in extremely preterm infants. |
| Databáze: | OpenAIRE |
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