Adverse neurodevelopmental outcome of moderate neonatal hypoglycaemia.
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TLDR
The data suggest that, contrary to general belief, moderate hypoglycaemia may have serious neurodevelopmental consequences, and reappraisal of current management is urgently required.Abstract:
There has been considerable debate over whether asymptomatic neonatal hypoglycaemia results in neurological damage. In a detailed multicentre study of 661 preterm infants hypoglycaemia was found to be common. Moderate hypoglycaemia (plasma glucose concentration less than 2.6 mmol/l) occurred in 433 of the infants and in 104 was found on three to 30 separate days. There was considerable variation among the centres, implying differences in decisions to intervene. The number of days on which moderate hypoglycaemia occurred was strongly related to reduced mental and motor development scores at 18 months (corrected age), even after adjustment for a wide range of factors known to influence development. When hypoglycaemia was recorded on five or more separate days adjusted mental and motor developmental scores at 18 months (corrected age) were significantly reduced by 14 and 13 points respectively, and the incidence of neurodevelopmental impairment (cerebral palsy or developmental delay) was increased by a factor of 3.5 (95% confidence interval 1.3 to 9.4). These data suggest that, contrary to general belief, moderate hypoglycaemia may have serious neurodevelopmental consequences, and reappraisal of current management is urgently required.read more
Citations
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Controversies regarding definition of neonatal hypoglycemia: suggested operational thresholds.
Marvin Cornblath,Jane M. Hawdon,Anthony F Williams,Albert Aynsley-Green,Martin P. Ward-Platt,Robert Schwartz,Satish C. Kalhan +6 more
TL;DR: Pragmatic recommendations for operational thresholds, ie, blood glucose levels at which clinical interventions should be considered, are offered in light of current knowledge to aid health care providers in neonatal medicine.
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Patterns of cerebral injury and neurodevelopmental outcomes after symptomatic neonatal hypoglycemia.
TL;DR: Pregnancy-induced hypertension, a family history of seizures, emergency cesarean section, and the need for resuscitation were more common among case subjects than control subjects and patterns of injury associated with symptomatic neonatal hypoglycemia were more varied than described previously.
Journal ArticleDOI
Neurodevelopment and Predictors of Outcomes of Children With Birth Weights of Less Than 1000 g: 1992-1995
Maureen Hack,Deanne E. Wilson-Costello,Harriet Friedman,Gerry H. Taylor,Mark D. Schluchter,Avroy A. Fanaroff +5 more
TL;DR: There is an urgent need for research into the etiology and prevention of neonatal morbidity in extremely low-birth-weight children and the significant predictors of outcome are identified.
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Calculation difficulties in children of very low birthweight: a neural correlate.
TL;DR: A neuroimaging study of adolescent children who had been born preterm at 30 weeks gestation or less is conducted, to investigate the relationship between brain structure and a specific difficulty in arithmetic calculation and establishes a structural neural correlate of calculation ability in a group of neurologically normal individuals.
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Diabetes and pregnancy.
David M. Thompson,Howard Berger,Denice S. Feig,Robert Gagnon,Tina Kader,Erin Keely,Sharon E. Kozak,Edmond A. Ryan,Mathew Sermer,Christina Vinokuroff +9 more
TL;DR: Although it is rare for IDDM to be recognised for the first time in pregnancy, this can happen and should always be borne in mind particularly if hyperglycaemia occurs early in the pregnancy.
References
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Alan Lucas,S M Gore,Tim J Cole,M F Bamford,J. F. B. Dossetor,I Barr,Dicarlo L,Cork S,P J Lucas +8 more
TL;DR: A major dietary effect on the number of days taken to regain birthweight and subsequent gains in weight, length, and head circumference was observed in the primary trial and similar though smaller differences in growth patterns were seen in the supplement trial.
Journal ArticleDOI
Neural dysfunction during hypoglycaemia.
TL;DR: The findings suggest that the blood glucose concentration should be maintained above 2.6 mmol/l to ensure normal neural function in children irrespective of the presence or absence of abnormal clinical signs.
Journal ArticleDOI
Incidence of hypoglycemia in newborn infants classified by birth weight and gestational age.
Lula O. Lubchenco,Harry Bard +1 more
TL;DR: The combination of reduced energy reserves in newborn infants with intra-uterine growth retardation, plus the increased utilization of carbohydrates during birth hypoxia, resulted in a high incidence of neonatal hypoglycemia in the first few hours after birth.
Journal ArticleDOI
Effects of neonatal hypoglycaemia on the nervous system: a pathological study.
TL;DR: The clinical histories and pathological findings in six patients are presented, three in whom hypoglycaemia was regarded as the major cause of death and three who died of other causes after the hypoglycanemia had been successfully treated.