title: Early blood glucose profile and neurodevelopmental outcome at two years in neonatal hypoxic-ischaemic encephalopathy.
abstract: BACKGROUND
  To examine the blood glucose profile and the relationship between blood glucose levels and neurodevelopmental outcome in term infants with hypoxic-ischaemic encephalopathy.
  
  
  METHODS
  Blood glucose values within 72 hours of birth were collected from 52 term infants with hypoxic-ischaemic encephalopathy. Hypoglycaemia [< 46.8 mg/dL (2.6 mmol/L)] and hyperglycaemia [> 150 mg/dL (8.3 mmol/L)] were correlated to neurodevelopmental outcome at 24 months of age.
  
  
  RESULTS
  Four fifths of the 468 blood samples were in the normoglycaemic range (392/468:83.8%). Of the remaining 76 samples, 51.3% were in the hypoglycaemic range and (48.7%) were hyperglycaemic. A quarter of the hypoglycaemic samples (28.2%:11/39) and a third of the hyperglycaemic samples (32.4%:12/37) were recorded within the first 30 minutes of life. Mean (SD) blood glucose values did not differ between infants with normal and abnormal outcomes [4.89(2.28) mmol/L and 5.02(2.35) mmol/L, p value = 0.15] respectively. In term infants with hypoxic-ischaemic encephalopathy, early hypoglycaemia (between 0-6 hours of life) was associated with adverse outcome at 24 months of age [OR = 5.8, CI = 1.04-32)]. On multivariate analysis to adjust for grade of HIE this association was not statistically significant. Late hypoglycaemia (6-72 hours of life) was not associated with abnormal outcome [OR = 0.22, CI (0.04-1.14)]. The occurrence of hyperglycaemia was not associated with adverse outcome.
  
  
  CONCLUSIONS
  During the first 72 hours of life, blood glucose profile in infants with hypoxic-ischaemic encephalopathy varies widely despite a management protocol. Early hypoglycaemia (0-6 hours of life) was associated with severe HIE, and thereby; adverse outcome.
authors.affiliation: Neonatal Intensive Care Unit, Cork University Maternity Hospital, Cork, Ireland.
authors.forename: Montasser
authors.initials: M
authors.lastname: Nadeem
authors.forename: Deirdre M
authors.initials: DM
authors.lastname: Murray
authors.forename: Geraldine B
authors.initials: GB
authors.lastname: Boylan
authors.forename: Eugene M
authors.initials: EM
authors.lastname: Dempsey
authors.forename: Cornelius A
authors.initials: CA
authors.lastname: Ryan
mesh_terms: D001238:Asphyxia Neonatorum / Q000097:blood* / Q000150:complications; D015415:Biomarkers; D001724:Birth Weight; D001786:Blood Glucose / Q000032:analysis*; D001925:Brain Damage, Chronic / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D005865:Gestational Age; D006801:Humans; D006943:Hyperglycemia / Q000151:congenital / Q000453:epidemiology; D007003:Hypoglycemia / Q000150:complications / Q000151:congenital / Q000453:epidemiology*; D007036:Hypothermia, Induced; D020925:Hypoxia-Ischemia, Brain / Q000097:blood* / Q000150:complications / Q000628:therapy; D007231:Infant, Newborn; D008297:Male; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D001786:Blood Glucose