title: Hyperglycemia in VLBW infants; incidence, risk factors and outcome.
abstract: BACKGROUND
  Neonatal hyperglycemia, which is relatively common in very low birth weight (VLBW) infants, is associated with increased risk of morbidity and mortality.
  
  
  OBJECTIVE
  To study the incidence of neonatal hyperglycemia, associated risk factors and the outcome of it in VLBW infants hospitalized in a level III NICU in Tehran.
  
  
  METHODS
  All VLBW newborns admitted to the NICU of Mahdieh Hospital from April 2009 to March 2011 were considered eligible for this retrospective study. All relevant prenatal and perinatal data, as well as details of the hospital stay until discharge or death, were extracted from the case notes and analyzed.
  
  
  RESULTS
  Hyperglycemia (blood suger above 150 mg/dL) was observed in 179 (31.7%) of the 564 VLBW infants included in the study; 48 infants (26.8%), had received insulin. Risk factors included: low gestational age, (OR = 4.07, 95% CI = 2.09-7.93, P < 0.001), extremely low birth weight (ELBW) , (OR = 5.97, 95% CI = 3.77-9.44, P < 0.001), dopamine administration (OR = 2.19, 95% CI = 1.32-3.65, P = 0.003), intralipid (OR = 1.52, 95% CI = 1.04-2.22, P = 0.03), Low APGAR score at 5 minutes (OR = 4.44, 95% CI = 2.48-7.94, P < 0.001), RDS and its complications (OR = 4.20, 95% CI = 2.55-6.93, P < 0.001), were independently associated with hyperglycemia. Other findings with hyperglycemia were: high incidence of IVH >grade II (OR = 2.88, 95% CI = 1.28-6.49, P = 0.01), hospital stay more than 28 days in survivors,(OR = 3.56, 95% CI = 2.02-6.25, P < 0.001), mortality (OR = 4.42, 95% CI = 3.00-6.52, P < 0.001) and more retinopathy of prematurity (ROP ≥ stage II) in survivors (OR = 2.05, 95% CI = 1.11-3.78, P = 0.02).
  
  
  CONCLUSIONS
  Neonatal hyperglycemia developed in approximately one-third of our VLBW neonates. Relative prevalence and associated findings underscore the need for preventive measures and prompt management.
authors.affiliation: Hamedan University of Medical Sciences, Hamedan, I.R. Iran. a_afjeh@sbmu.ac.ir.
authors.forename: Mohammad Kazem
authors.initials: MK
authors.lastname: Sabzehei
authors.affiliation: 1)Pediatric Infections Research Center, Shahid Beheshti University of Medical Sciences, Tehran, I.R. Iran. 3)Mahdieh Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, I.R. Iran.
authors.forename: Seyyed Abolfazl
authors.initials: SA
authors.lastname: Afjeh
authors.affiliation: Mofid Children Hospital, Shahid Beheshti University of Medical Sciences, Tehran, I.R. Iran.
authors.forename: Marjan
authors.initials: M
authors.lastname: Shakiba
authors.affiliation: Mofid Cchildren Hospital, Shahid Beheshti University of Medical Sciences, Tehran, I.R. Iran.
authors.forename: Parinaz
authors.initials: P
authors.lastname: Alizadeh
authors.affiliation: Dental Research Center, Dentistry Research Institute, Department of Community Oral Health, School of Dentistry, Tehran University of Medical Sciences, Tehran, I.R. Iran.
authors.forename: Ahmad Reza
authors.initials: AR
authors.lastname: Shamshiri
authors.affiliation: Mahdieh Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, I.R. Iran.
authors.forename: Fatemeh
authors.initials: F
authors.lastname: Esmaili
mesh_terms: D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000453:epidemiology* / Q000209:etiology; D015994:Incidence; D007223:Infant; D019102:Infant, Very Low Birth Weight; D008297:Male; D012178:Retinopathy of Prematurity / Q000453:epidemiology; D012307:Risk Factors