title: Early hyperglycemia is a risk factor for death and white matter reduction in preterm infants.
abstract: OBJECTIVE
  The objective of this study was to determine whether hyperglycemia during the first week of life in extremely preterm (EPT) infants was associated with increased mortality rates and with cerebral injury, as assessed with MRI of the brain, at term-equivalent age.
  
  
  METHODS
  All 143 EPT infants (gestational ages of <27 weeks) who were born at Karolinska University Hospital between January 2004 and December 2006 and were alive at 24 hours were eligible. Of the 118 surviving infants, 24 were excluded for various reasons. MRI was performed for the 94 included survivors at term age, with a 1.5-T system, and scans were scored for gray matter/white matter (WM) abnormalities. Of the 25 infants who died before term age, 6 were excluded because of missing glucose documentation and the remaining 19 were included. Hyperglycemia was defined as plasma glucose levels of >8.3 mmol/L.
  
  
  RESULTS
  Hyperglycemia occurring on the first day of life was identified as an independent risk factor for death (adjusted odds ratio: 3.7 [95% confidence interval: 1.3-10.6]; P = .01). Hyperglycemia occurring on the first day of life also was a risk factor for WM reduction, as determined through MRI, at term-equivalent age (adjusted odds ratio: 3.1 [95% confidence interval: 1.0-9.2]; P = .04).
  
  
  CONCLUSIONS
  In this population-based cohort of EPT infants, hyperglycemia on the first day of life was associated with increased mortality rates and brain damage, as reflected by WM reduction at term age.
authors.affiliation: Neonatal Unit, Astrid Lindgren Children's Hospital/Karolinska University Hospital, SE-171 77 Stockholm, Sweden.
authors.forename: Georgios
authors.initials: G
authors.lastname: Alexandrou
authors.forename: Beatrice
authors.initials: B
authors.lastname: Skiöld
authors.forename: Jonna
authors.initials: J
authors.lastname: Karlén
authors.forename: Mesfin K
authors.initials: MK
authors.lastname: Tessma
authors.forename: Mikael
authors.initials: M
authors.lastname: Norman
authors.forename: Ulrika
authors.initials: U
authors.lastname: Adén
authors.forename: Mireille
authors.initials: M
authors.lastname: Vanpée
mesh_terms: D000367:Age Factors; D001927:Brain Diseases / Q000175:diagnosis / Q000209:etiology*; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000150:complications* / Q000401:mortality*; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000401:mortality*; D008279:Magnetic Resonance Imaging; D008297:Male; D012189:Retrospective Studies; D012307:Risk Factors