
Association between Glycaemia and Neurodevelopmental Outcome at One Year of Age among Term Neonates At-risk for Hypoglycaemia: A Prospective Cohort Study
Correspondence Address :
Karthikeyan Kadirvel,
Professor, Department of Paediatrics, Mahatma Gandhi Medical College and Research Institute, Puducherry, India.
E-mail: drkk3179@gmail.com
Introduction: Hypoglycaemia during the newborn period is especially impactful because the brain is dynamically developing. The most common sequelae of hypoglycaemia are disturbances in neurologic development and intellectual function; although minor deficits, especially spasticity, ataxia and seizure disorders, can also occur.
Aim: To assess the association between glycaemia and neurodevelopmental outcomes at one year of age among term neonates at-risk for hypoglycaemia.
Materials and Methods: This prospective cohort study was conducted at the Department of Paediatrics, Mahatma Gandhi Medical College and Research Institute (a tertiary care hospital), Puducherry, India between November 2020 and July 2022. It involved a cohort of neonates at-risk for hypoglycaemia with a gestational age of ≥35 weeks who underwent intermittent monitoring of Blood Glucose (BG) for up to 72 hours of life. The estimated sample size was 146. Assessment at one year included Developmental Assessment Score for Indian Infants (DASII) scores and Amiel-Tison angles, with the assessor being masked to the neonatal glycaemic status.
Results: Of the 146 neonates, 71 were euglycaemic and 74 were hypoglycaemic (57 asymptomatic and 17 symptomatic). The mean birth weights were 2853±0.61 grams for euglycaemic neonates, 2669±0.62 grams for asymptomatic hypoglycaemic neonates and 2965±0.671 grams for symptomatic hypoglycaemic neonates. Three of the 74 hypoglycaemic infants developed cerebral palsy. The mean Motor and Mental Developmental Quotients (MoDQ and MeDQ) were significantly lower at one year in any hypoglycaemic infants compared to euglycaemic infants (p<0.001). A BG level of <40 mg/dL demonstrated 98.9% sensitivity for MoDQ and 100% sensitivity for MeDQ, respectively. The Area Under the Curve (AUC) was 0.958 for MoDQ and 0.812 for MeDQ, respectively.
Conclusion: Hypoglycaemia, regardless of whether it is symptomatic or asymptomatic, is associated with poor neurodevelopmental outcomes. All at-risk neonates should be monitored to prevent any episodes of hypoglycaemia.
Blood glucose, Infant, Neonates, Neurodevelopmental disorders
DOI: 10.7860/JCDR/2025/76013.20730
Date of Submission: Oct 03, 2024
Date of Peer Review: Oct 26, 2024
Date of Acceptance: Feb 24, 2025
Date of Publishing: Mar 01, 2025
AUTHOR DECLARATION:
• Financial or Other Competing Interests: None
• Was Ethics Committee Approval obtained for this study? Yes
• Was informed consent obtained from the subjects involved in the study? Yes
• For any images presented appropriate consent has been obtained from the subjects. NA
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ETYMOLOGY: Author Origin
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