Neurodevelopmental outcome of hypoglycaemia in healthy, large for gestational age, term newborns.
OBJECTIVE
To evaluate the effects of transient hypoglycaemia on the first day of life in 75 healthy term large for gestational age (LGA) infants, born to non-diabetic mothers, on their neurodevelopmental outcome at the age of 4 years.


METHODS
Screening for hypoglycaemia was performed 1, 3, and 5 hours after birth, and continued if blood glucose levels were low. Treatment with intravenous glucose for hypoglycaemia was started if hypoglycaemia was severe or symptomatic. Patients' development and behaviour was examined at the age of 4 years by the Denver Developmental Scale, a non-verbal intelligence test, and the Child Behaviour Check List.


RESULTS
There were no significant differences between children with neonatal normoglycaemia (n = 15) and hypoglycaemia (plasma glucose <2.2 mmol/l 1 hour after birth, or <2.5 mmol/l subsequently; n = 60) in Denver developmental scale scores and child behaviour checklist scores. Although total IQ did not differ between hypoglycaemic and normoglycaemic children, one subscale (reasoning) did (mean difference 9.3, 95% CI 1.3 to 17.2). The correlation between reasoning IQ and neonatal blood glucose levels was weak and not statistically significant. When other definitions for hypoglycaemia were applied, the difference in reasoning IQ was not found. There were no differences in any of the test scores between hypoglycaemic children who had and who had not been treated with intravenous glucose.


CONCLUSIONS
Transient mild hypoglycaemia in healthy, term LGA newborns does not appear to be harmful to psychomotor development at the age of 4 years.
Brand
P L P
PL
Department of Paediatrics, Isala klinieken, PO Box 10500, 8000 GM Zwolle, Netherlands. p.l.p.brand@isala.nl
Molenaar
N L D
NL
Kaaijk
C
C
Wierenga
W S
WS
D001724:Birth Weight; D001786:Blood Glucose / Q000032:analysis; D002653:Child Behavior Disorders / Q000209:etiology*; D002675:Child, Preschool; D002658:Developmental Disabilities / Q000209:etiology*; D005260:Female; D005865:Gestational Age; D005947:Glucose / Q000627:therapeutic use; D006801:Humans; D007003:Hypoglycemia / Q000188:drug therapy / Q000523:psychology*; D007231:Infant, Newborn; D008297:Male; D011581:Psychological Tests
D001786:Blood Glucose; D005947:Glucose