title: Associated factors in neonatal hypoglycemic brain injury.
abstract: Although associated factors are important for the occurrence of neural damage in neonatal hypoglycemia, they are not fully understood. Sixty patients with neonatal hypoglycemia were studied through a review of their medical records in Tottori University Hospital. The patients were classified into two main groups: Group I were patients who had mental retardation, developmental delay, cerebral palsy or epilepsy while Group II were those who were normal in their follow-up. Group I consisted of 12 patients while Group II consisted of 48 patients. The median gestational age was 38 weeks in Group I and 36.7 weeks in Group II. The frequencies of small for gestational age were similar in both groups. Blood glucose levels less than 15 mg/dl were more frequent in Group 1 (50.0%) than in Group 2 (14.6%) (P=0.015). Duration of hypoglycemia was longer in Group I (median, 14 h) than in Group II (median, 1.75 h) (p<0.001). The following factors were more frequent in Group I than in Group II: toxemia (33.3% and 8.3%, p=0.043), fetal distress (58.3% and 14.5%, p=0.004), an Apgar score of less than 5 at 1 min (33.3% and 6.4%, p=0.025), neonatal seizure (53.8% and 4.3%, p<0.001) and pathological jaundice (41.7% and 6.4%, p=0.006). Cranial CT or MRI revealed cerebral lesions in 8 of the 9 Group I patients in follow-up examinations. This study indicates that severe and prolonged neonatal hypoglycemia can cause cerebral lesions and other perinatal risk factors, such as hypoxia, neonatal seizure and pathological jaundice, would exacerbate hypoglycemic brain injuries.
authors.affiliation: Division of Child Neurology, Institute of Neurological Sciences, Faculty of Medicine, Tottori University, Yonago, Japan. hishammontassir@gmail.com
authors.forename: Hesham
authors.initials: H
authors.lastname: Montassir
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Maegaki
authors.forename: Kaeko
authors.initials: K
authors.lastname: Ogura
authors.forename: Youichi
authors.initials: Y
authors.lastname: Kurozawa
authors.forename: Ikuo
authors.initials: I
authors.lastname: Nagata
authors.forename: Susumu
authors.initials: S
authors.lastname: Kanzaki
authors.forename: Kousaku
authors.initials: K
authors.lastname: Ohno
mesh_terms: D001284:Atrophy / Q000473:pathology; D001724:Birth Weight; D001786:Blood Glucose / Q000378:metabolism*; D001921:Brain / Q000473:pathology*; D001930:Brain Injuries / Q000000981:diagnostic imaging / Q000209:etiology* / Q000473:pathology; D002658:Developmental Disabilities / Q000209:etiology; D018450:Disease Progression; D004569:Electroencephalography; D005260:Female; D005500:Follow-Up Studies; D005865:Gestational Age; D005947:Glucose / Q000627:therapeutic use; D006801:Humans; D007003:Hypoglycemia / Q000150:complications* / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000473:pathology; D007231:Infant, Newborn; D008279:Magnetic Resonance Imaging; D008297:Male; D015999:Multivariate Analysis; D011859:Radiography; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D012737:Sex Factors; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D001786:Blood Glucose; D005947:Glucose