Neurodevelopmental outcome of asymptomatic hypoglycemia in comparison to symptomatic hypoglycemia and euglycemia in high risk neonates

Publication date: Available online 7 June 2017
Source:Pediatric Neurology
Author(s): Gagan Mahajan, Kanya Mukhopadhyay, Savita Attri, Praveen Kumar
AimsTo assess the neurodevelopmental outcome of asymptomatic neonatal hypoglycemia at 1 year and to compare it with symptomatic hypoglycemic and euglycemic neonates .MethodSeventy two hypoglycemic (plasma glucose <50 mg/dl) neonates, both symptomatic (n=27) and asymptomatic (n=45) and 70 weight and gestation matched euglycemic neonates who were > 32 weeks gestation, enrolled during 1^st week of life and assessed for neurodevelopmental outcome at corrected age (CA) 6 and 12 months ( n=67 and 62 in hypoglycemia group and 63 and 54 in euglycemia group, rest lost to follow up and death=1) .ResultsAt 1 year, 8% (5 of 62, 4 in symptomatic and 1 in asymptomatic group) hypoglycemic neonates developed Cerebral Palsy. Mean Motor and Mental DQ were significantly lower at CA 6 and 12 months in any hypoglycemia (p <0.001) and if blood glucose was < 40 mg/dl (p < 0.001) as compared to euglycemia. Symptomatic infants had lower MoDQ (p= 0.004 and 0.003) and MeDQ (p= 0.001 and 0.001) at CA 6 and 12 months than asymptomatic infants and asymptomatic infants had lower MoDQ (p= < 0.001and 0.004) and MeDQ (p= 0.001 and 0.004) than euglycemic group at CA 6 and 12 months respectively. Blood glucose of < 40 mg/dl had high sensitivity (83% for MoDQ and 81% for MeDQ) for DQ scores of < 85.ConclusionHypoglycemia, both symptomatic and asymptomatic lead to adverse neurodevelopmental outcome as compared to euglycemia though it was worse in symptomatic group and at blood glucose < 40 mg/dl.



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