Glucose abnormalities in infants with birth asphyxia are associated with later neurological diagnoses

Abstract

<h3>Objective</h3><p>To investigate the association between early glycemic profile and neurological outcome in neonates with birth asphyxia.</p><h3>Study design</h3><p>Retrospective single-center study on infants born ≥36 weeks gestational age with an ICD-10 diagnosis of birth asphyxia and/or hypoxic-ischemic encephalopathy, using early (<72 h) glucose values and clinical follow-up data extracted from medical records. Outcomes: death or any ICD-10 diagnoses indicating neurodevelopmental disorders (NDD; psychiatric, epileptical, paralytical, visual or hearing disorders) and individual diagnostic classes. Estimates were adjusted for infant sex, delivery mode and therapeutic hypothermia.</p><h3>Results</h3><p>Among 272 neonates, 44 infants received therapeutic hypothermia and 228 infants did not. In multivariate analyses of all infants, the association was significant between glucose <2.6 mmol/l and hearing disorders (aOR = 6.7, 95%CI 1.2–37.3). Glucose >8.3 mmol/l was significantly associated with cerebral palsy (OR = 4.5, 95%Cl 1.2–16.4) and hearing disorders (OR = 6.1, 95%Cl 1.2–29.7). In univariate analyses of the 228 infants who did not receive therapeutic hypothermia, both hypoglycemia and hyperglycemia were associated with cerebral palsy: glucose <2.6 mmol/l: OR 5.63 (1.1–29.7) and >8.3 mmol/l OR 8.83 (1.88–41.47); epilepsy: glucose <1.6 mmol/l: OR 12.2 (1.6–91.9) and >8.3 mmol/l 19.4 (2.0–192.6); and hearing disorders: glucose<1.6 mmol/l OR 8.1 (1.3–51.7) and >8.3 mmol/l OR 9.7 (1.6–60.2).</p><h3>Conclusions</h3><p>This study suggests that the glycemic profile in neonates with birth asphyxia during the first 72 h is associated with neurodevelopmental disorders. Further research is needed to verify these findings and investigate if neurological outcome could be improved by rigorous glycemic control.</p>