Early human development · 2026
Glucose abnormalities in infants with birth asphyxia are associated with later neurological diagnoses.
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Viitaharju Niina, Parikka Vilhelmiina, Löyttyniemi Eliisa, Singh Bishwesvar, Helenius Kjell
Аннотация
OBJECTIVE: To investigate the association between early glycemic profile and neurological outcome in neonates with birth asphyxia.
STUDY DESIGN: Retrospective single-center study on infants born ≥36 weeks gestational age with an ICD-10 diagnosis of birth asphyxia and/or hypoxic-ischemic encephalopathy, using early (<72 h) glucose values and clinical follow-up data extracted from medical records.
OUTCOMES: death or any ICD-10 diagnoses indicating neurodevelopmental disorders (NDD; psychiatric, epileptical, paralytical, visual or hearing disorders) and individual diagnostic classes. Estimates were adjusted for infant sex, delivery mode and therapeutic hypothermia.
RESULTS: Among 272 neonates, 44 infants received therapeutic hypothermia and 228 infants did not. In multivariate analyses of all infants, the association was significant between glucose <2.6 mmol/l and hearing disorders (aOR = 6.7, 95%CI 1.2-37.3). Glucose >8.3 mmol/l was significantly associated with cerebral palsy (OR = 4.5, 95%Cl 1.2-16.4) and hearing disorders (OR = 6.1, 95%Cl 1.2-29.7). In univariate analyses of the 228 infants who did not receive therapeutic hypothermia, both hypoglycemia and hyperglycemia were associated with cerebral palsy: glucose <2.6 mmol/l: OR 5.63 (1.1-29.7) and >8.3 mmol/l OR 8.83 (1.88-41.47); epilepsy: glucose <1.6 mmol/l: OR 12.2 (1.6-91.9) and >8.3 mmol/l 19.4 (2.0-192.6); and hearing disorders: glucose<1.6 mmol/l OR 8.1 (1.3-51.7) and >8.3 mmol/l OR 9.7 (1.6-60.2).
CONCLUSIONS: This study suggests that the glycemic profile in neonates with birth asphyxia during the first 72 h is associated with neurodevelopmental disorders. Further research is needed to verify these findings and investigate if neurological outcome could be improved by rigorous glycemic control.
STUDY DESIGN: Retrospective single-center study on infants born ≥36 weeks gestational age with an ICD-10 diagnosis of birth asphyxia and/or hypoxic-ischemic encephalopathy, using early (<72 h) glucose values and clinical follow-up data extracted from medical records.
OUTCOMES: death or any ICD-10 diagnoses indicating neurodevelopmental disorders (NDD; psychiatric, epileptical, paralytical, visual or hearing disorders) and individual diagnostic classes. Estimates were adjusted for infant sex, delivery mode and therapeutic hypothermia.
RESULTS: Among 272 neonates, 44 infants received therapeutic hypothermia and 228 infants did not. In multivariate analyses of all infants, the association was significant between glucose <2.6 mmol/l and hearing disorders (aOR = 6.7, 95%CI 1.2-37.3). Glucose >8.3 mmol/l was significantly associated with cerebral palsy (OR = 4.5, 95%Cl 1.2-16.4) and hearing disorders (OR = 6.1, 95%Cl 1.2-29.7). In univariate analyses of the 228 infants who did not receive therapeutic hypothermia, both hypoglycemia and hyperglycemia were associated with cerebral palsy: glucose <2.6 mmol/l: OR 5.63 (1.1-29.7) and >8.3 mmol/l OR 8.83 (1.88-41.47); epilepsy: glucose <1.6 mmol/l: OR 12.2 (1.6-91.9) and >8.3 mmol/l 19.4 (2.0-192.6); and hearing disorders: glucose<1.6 mmol/l OR 8.1 (1.3-51.7) and >8.3 mmol/l OR 9.7 (1.6-60.2).
CONCLUSIONS: This study suggests that the glycemic profile in neonates with birth asphyxia during the first 72 h is associated with neurodevelopmental disorders. Further research is needed to verify these findings and investigate if neurological outcome could be improved by rigorous glycemic control.