PMID- 29637170
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220317
IS  - 2399-9772 (Electronic)
IS  - 2399-9772 (Linking)
VI  - 1
IP  - 1
DP  - 2017
TI  - Impact of hypoglycaemia on neurodevelopmental outcomes in hypoxic ischaemic 
      encephalopathy: a retrospective cohort study.
PG  - e000175
LID - 10.1136/bmjpo-2017-000175 [doi]
LID - e000175
AB  - BACKGROUND: Low blood glucose levels (BGLs) in infants are known to adversely 
      affect neurodevelopmental outcomes. However, this risk is not well explored in 
      infants with hypoxic ischaemic encephalopathy (HIE) that receive therapeutic 
      hypothermia (TH). Additionally, little information is available on the optimal 
      BGLs to target in infants with HIE. AIM: To explore the association between 
      hypoglycaemia and neurodevelopmental outcomes at different BGL thresholds (2.6 
      and 3.0 mmol/L) in neonates with HIE treated with TH. METHODS: Retrospective 
      cohort study. Clinical information and 2-year neurodevelopmental data using 
      Bayley Scales of Infant Development, third edition (BSID-III) and disabilities 
      were recorded for infants born in Western Australia with HIE and treated with TH 
      between February 2008 and February 2012. Multivariable logistic regression models 
      explored the association between hypoglycaemia and neurodevelopmental outcomes. 
      RESULTS: 122 infants underwent a total of 1616 BGL estimations before and during 
      72 hours of TH. Hypoglycaemia (BGL<2.6 mmol/L) occurred in 38/122 (31%) infants 
      and 11/122 (9%) had recurrent hypoglycaemia (three or more episodes). Infants 
      with recurrent hypoglycaemia (<2.6 mmol/L) had significantly lower mean BSID-III 
      cognitive, language and socioemotional subscale scores. On multivariable 
      analysis, recurrent hypoglycaemia (<2.6 mmol/L) was associated with increased 
      odds of death or disability (adjusted OR 8.15; 95% CI 1.31 to 50.58; p=0.024). 
      Recurrent hypoglycaemia (<3.0 mmol/L) during the first 12 hours of life was also 
      associated with severe disability among survivors (adjusted OR 11.13; 95% CI 2.06 
      to 59.89; p=0.005). CONCLUSIONS: Early recurrent hypoglycaemia was associated 
      with increased risk of death or severe disability in neonates undergoing TH for 
      HIE. Prospective studies are needed to identify the ideal target BGL in this 
      population.
FAU - Tan, Jason Khay Ghim
AU  - Tan JKG
AD  - Neonatal Intensive Care Unit, Princess Margaret Hospital for Children, Perth, 
      Western Australia, Australia.
AD  - Centre for Neonatal Research and Education, The University of Western Australia, 
      Perth, Western Australia, Australia.
FAU - Minutillo, Corrado
AU  - Minutillo C
AD  - Neonatal Intensive Care Unit, Princess Margaret Hospital for Children, Perth, 
      Western Australia, Australia.
AD  - Centre for Neonatal Research and Education, The University of Western Australia, 
      Perth, Western Australia, Australia.
FAU - McMichael, Judy
AU  - McMichael J
AD  - Centre for Neonatal Research and Education, The University of Western Australia, 
      Perth, Western Australia, Australia.
AD  - State Child Development Centre, Perth, Western Australia, Australia.
FAU - Rao, Shripada
AU  - Rao S
AD  - Neonatal Intensive Care Unit, Princess Margaret Hospital for Children, Perth, 
      Western Australia, Australia.
AD  - Centre for Neonatal Research and Education, The University of Western Australia, 
      Perth, Western Australia, Australia.
LA  - eng
PT  - Journal Article
DEP - 20170918
PL  - England
TA  - BMJ Paediatr Open
JT  - BMJ paediatrics open
JID - 101715309
PMC - PMC5862228
OTO - NOTNLM
OT  - neonatology
OT  - neurodevelopment
COIS- Competing interests: None declared.
EDAT- 2018/04/11 06:00
MHDA- 2018/04/11 06:01
PMCR- 2017/09/18
CRDT- 2018/04/12 06:00
PHST- 2017/07/14 00:00 [received]
PHST- 2017/08/16 00:00 [revised]
PHST- 2017/08/17 00:00 [accepted]
PHST- 2018/04/12 06:00 [entrez]
PHST- 2018/04/11 06:00 [pubmed]
PHST- 2018/04/11 06:01 [medline]
PHST- 2017/09/18 00:00 [pmc-release]
AID - bmjpo-2017-000175 [pii]
AID - 10.1136/bmjpo-2017-000175 [doi]
PST - epublish
SO  - BMJ Paediatr Open. 2017 Sep 18;1(1):e000175. doi: 10.1136/bmjpo-2017-000175. 
      eCollection 2017.