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BMC Pediatrics
Published in: BMC Pediatrics 1/2010

Open Access 01-12-2010 | Research article

Short and long term outcome of neonatal hyperglycemia in very preterm infants: a retrospective follow-up study

Authors: N Margreth van der Lugt, Vivianne EHJ Smits-Wintjens, Paul HT van Zwieten, Frans J Walther

Published in: BMC Pediatrics | Issue 1/2010

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Abstract

Background

Hyperglycemia in premature infants is associated with increased morbidity and mortality, but data on long-term outcome are limited. We investigated the effects of neonatal hyperglycemia (blood glucose ≥ 10 mmol/l, treated with insulin for ≥ 12 hours) on growth and neurobehavioral outcome at 2 years of age.

Methods

Retrospective follow-up study at 2 years of age among 859 infants ≤32 weeks of gestation admitted to a tertiary neonatal center between January 2002 and December 2006. Thirty-three survivors treated with insulin for hyperglycemia and 63 matched controls without hyperglycemia were evaluated at a corrected age of 2 years. Outcome measures consisted of growth (weight, length, and head circumference) and neurological and behavioural development.

Results

66/859 (8%) infants ≤ 32 weeks of gestation developed hyperglycemia. Mortality during admission was 27/66 (41%) in the hyperglycemia group versus 62/793 (8%) in those without hyperglycemia (p < 0.001). Mortality was higher in infants with hyperglycemia with a birth weight ≤1,000 gram (p = 0.005) and/or gestational age of 24-28 weeks (p = 0.009) than in control infants without hyperglycemia. Sepsis was more prominent in infants with hyperglycemia and a birth weight of >1,000 gram (p = 0.002) and/or gestational age of 29-32 weeks (p = 0.009) than in control infants without hyperglycemia. Growth at 2 years of age was similar, but neurological and behavioural development was more frequently abnormal among those with neonatal hyperglycemia (p = 0.036 and 0.021 respectively).

Conclusions

Mortality was higher in very preterm infants with hyperglycemia treated with insulin during the neonatal period. At 2 years of age survivors showed normal growth, but a higher incidence of neurological and behavioural problems. Better strategies to manage hyperglycemia may improve outcome of very preterm infants.
Appendix
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Metadata
Title
Short and long term outcome of neonatal hyperglycemia in very preterm infants: a retrospective follow-up study
Authors
N Margreth van der Lugt
Vivianne EHJ Smits-Wintjens
Paul HT van Zwieten
Frans J Walther
Publication date
01-12-2010
Publisher
BioMed Central
Published in
BMC Pediatrics / Issue 1/2010
Electronic ISSN: 1471-2431
DOI
https://doi.org/10.1186/1471-2431-10-52

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