Long-term effects of neonatal hypoglycemia on brain growth and psychomotor development in small-for-gestational-age preterm infants.
OBJECTIVE
To investigate the effects of neonatal hypoglycemia on physical growth and neurocognitive function.


METHODS
A systematic detection of hypoglycemia (<2.6 mmol/L or 47 mg/dL) was carried out in 85 small-for-gestational-age preterm neonates. Prospective serial evaluations of physical growth and psychomotor development were performed. Retrospectively, infants were grouped according to their glycemic status.


RESULTS
The incidence of hypoglycemia was 72.9%. Infants with repeated episodes of hypoglycemia had significantly reduced head circumferences and lower scores in specific psychometric tests at 3.5 years of age. Hypoglycemia also caused reduced head circumferences at 18 months and lower psychometric scores at 5 years of age. Infants with moderate recurrent hypoglycemia had lower scores at 3.5 and 5 years of age compared with the group of infants who had 1 single severe hypoglycemic episode.


CONCLUSIONS
Recurrent episodes of hypoglycemia were strongly correlated with persistent neurodevelopmental and physical growth deficits until 5 years of age. Recurrent hypoglycemia also was a more predictable factor for long-term effects than the severity of a single hypoglycemic episode. Therefore repetitive blood glucose monitoring and rapid treatment even for mild hypoglycemia are recommended for small-for-gestational-age infants in the neonatal period.
Duvanel
C B
CB
Department of Pediatrics and the Department of Gynecology and Obstetrics, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
Fawer
C L
CL
Cotting
J
J
Hohlfeld
P
P
Matthieu
J M
JM
D001786:Blood Glucose; D001921:Brain / Q000254:growth & development*; D002658:Developmental Disabilities / Q000209:etiology*; D005260:Female; D006257:Head / Q000254:growth & development; D006801:Humans; D007003:Hypoglycemia / Q000145:classification / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology; D015994:Incidence; D007231:Infant, Newborn; D007234:Infant, Premature; D007236:Infant, Small for Gestational Age / Q000097:blood / Q000254:growth & development / Q000523:psychology; D008297:Male; D008423:Maternal Age; D011594:Psychometrics; D011597:Psychomotor Performance; D012016:Reference Values; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D012923:Social Class
D001786:Blood Glucose