Dokument: Transitional Neonatal Hypoglycemia and Adverse Neurodevelopment in Midchildhood

Titel:Transitional Neonatal Hypoglycemia and Adverse Neurodevelopment in Midchildhood
URL für Lesezeichen:https://docserv.uni-duesseldorf.de/servlets/DocumentServlet?id=68404
URN (NBN):urn:nbn:de:hbz:061-20250203-104423-4
Kollektion:Publikationen
Sprache:Englisch
Dokumententyp:Wissenschaftliche Texte » Artikel, Aufsatz
Medientyp:Text
Autoren: Roeper, Marcia [Autor]
Hoermann, Henrike [Autor]
Körner, Lisa M. [Autor]
Sobottka, Marvin [Autor]
Mayatepek, Ertan [Autor]
Kummer, Sebastian [Autor]
Meissner, Thomas [Autor]
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Dateien vom 03.02.2025 / geändert 03.02.2025
Beschreibung:Importance
The circumstances under which neonatal hypoglycemia leads to brain damage remain unclear due to a lack of long-term data on the neurodevelopment of affected children. As a result, diagnostic strategies and treatment recommendations are inconsistent.

Objective
To evaluate whether the occurrence of severe transitional neonatal hypoglycemia (defined as having at least 1 blood glucose measurement of 30 mg/dL or below) is associated with adverse neurodevelopment in midchildhood.

Design, Setting, and Participants
This cohort study using neurodevelopmental testing of a retrospectively recruited cohort was conducted at a single-center tertiary hospital in Germany between March 2022 and February 2023. Children with neonatal blood glucose screening data were randomly selected from all births between 2010 and 2015. Frequency matching for sex, birth weight, gestational age, socioeconomic status, and primary risk factors for neonatal hypoglycemia was performed. Children with persistent hypoglycemia diseases or any risk factor for adverse neurodevelopment except hypoglycemia were excluded. Data were analyzed between February 2023 and March 2023.

Exposure
At least 1 neonatal hypoglycemia measurement with blood glucose measuring 30 mg/dL or below vs all measured blood glucose levels above 30 mg/dL during postnatal blood glucose screening starting on the first day of life.

Main Outcomes and Measures
Cognitive function measured by full-scale IQ test. Secondary outcomes included standardized scales of motor, visual, and executive functions, and child behavior, each measured at ages 7 to 11 years.

Results
A total of 140 children (mean [SD] age 9.1 [1.3] years; 77 male [55.0%]) participated in the study. Children with severe neonatal hypoglycemia had a 4.8 points lower mean full-scale IQ than controls (107.0 [95% CI, 104.0-109.9] vs 111.8 [95% CI, 108.8-114.8]). They showed a 4.9-fold (95% CI, 1.5-15.5) increased odds of abnormal fine motor function and a 5.3-fold (95% CI, 2.1-13.3) increased odds of abnormal visual-motor integration. Significantly higher T scores for attention problems (58.2 [95% CI, 56.1-60.2] vs 54.6 [95% CI, 52.6-56.6]) and attention-deficit/hyperactivity disorder symptoms (58.2 [95% CI, 56.2-60.2] vs 54.7 [95% CI, 52.8-56.7]) were reported by parents.

Conclusions and Relevance
Neonatal hypoglycemia with blood glucose levels of 30 mg/dL or below was associated with an increased risk for suboptimal neurodevelopmental outcomes in midchildhood. These findings imply that treatment strategies should aim to prevent episodes of hypoglycemia at these severely low levels.
Rechtliche Vermerke:Originalveröffentlichung:
Röper, M., Hörmann, H., Körner, L. M., Sobottka, M., Mayatepek, E., Kummer, S., & Meißner, T. (2024). Transitional Neonatal Hypoglycemia and Adverse Neurodevelopment in Midchildhood. JAMA Network Open, 7(3), Article e243683. https://doi.org/10.1001/jamanetworkopen.2024.3683
Lizenz:Creative Commons Lizenzvertrag
Dieses Werk ist lizenziert unter einer Creative Commons Namensnennung 4.0 International Lizenz
Fachbereich / Einrichtung:Medizinische Fakultät
Dokument erstellt am:03.02.2025
Dateien geändert am:03.02.2025
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