Skip to main content
PMC home page
The BMJ logoLink to The BMJ
. 1988 Nov 19;297(6659):1304–1308. doi: 10.1136/bmj.297.6659.1304

Adverse neurodevelopmental outcome of moderate neonatal hypoglycaemia.

A Lucas 1, R Morley 1, T J Cole 1
PMCID: PMC1834933  PMID: 2462455

Abstract

There has been considerable debate over whether asymptomatic neonatal hypoglycaemia results in neurological damage. In a detailed multicentre study of 661 preterm infants hypoglycaemia was found to be common. Moderate hypoglycaemia (plasma glucose concentration less than 2.6 mmol/l) occurred in 433 of the infants and in 104 was found on three to 30 separate days. There was considerable variation among the centres, implying differences in decisions to intervene. The number of days on which moderate hypoglycaemia occurred was strongly related to reduced mental and motor development scores at 18 months (corrected age), even after adjustment for a wide range of factors known to influence development. When hypoglycaemia was recorded on five or more separate days adjusted mental and motor developmental scores at 18 months (corrected age) were significantly reduced by 14 and 13 points respectively, and the incidence of neurodevelopmental impairment (cerebral palsy or developmental delay) was increased by a factor of 3.5 (95% confidence interval 1.3 to 9.4). These data suggest that, contrary to general belief, moderate hypoglycaemia may have serious neurodevelopmental consequences, and reappraisal of current management is urgently required.

Full text

PDF
1306

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Anderson J. M., Milner R. D., Strich S. J. Effects of neonatal hypoglycaemia on the nervous system: a pathological study. J Neurol Neurosurg Psychiatry. 1967 Aug;30(4):295–310. doi: 10.1136/jnnp.30.4.295. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Beard A., Cornblath M., Gentz J., Kellum M., Persson B., Zetterström R., Haworth J. C. Neonatal hypoglycemia: a discussion. J Pediatr. 1971 Aug;79(2):314–324. doi: 10.1016/s0022-3476(71)80123-3. [DOI] [PubMed] [Google Scholar]
  3. Fluge G. Clinical aspects of neonatal hypoglycaemia. Acta Paediatr Scand. 1974 Nov;63(6):826–832. doi: 10.1111/j.1651-2227.1974.tb04871.x. [DOI] [PubMed] [Google Scholar]
  4. Fluge G. Neurological findings at follow-up in neonatal hypoglycaemia. Acta Paediatr Scand. 1975 Jul;64(4):629–634. doi: 10.1111/j.1651-2227.1975.tb03894.x. [DOI] [PubMed] [Google Scholar]
  5. Griffiths A. D., Bryant G. M. Assessment of effects of neonatal hypoglycaemia. A study of 41 cases with matched controls. Arch Dis Child. 1971 Dec;46(250):819–827. doi: 10.1136/adc.46.250.819. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Gutberlet R. L., Cornblath M. Neonatal hypoglycemia revisited, 1975. Pediatrics. 1976 Jul;58(1):10–17. [PubMed] [Google Scholar]
  7. Koivisto M., Blanco-Sequeiros M., Krause U. Neonatal symptomatic and asymptomatic hypoglycaemia: a follow-up study of 151 children. Dev Med Child Neurol. 1972 Oct;14(5):603–614. doi: 10.1111/j.1469-8749.1972.tb02642.x. [DOI] [PubMed] [Google Scholar]
  8. Lubchenco L. O., Bard H. Incidence of hypoglycemia in newborn infants classified by birth weight and gestational age. Pediatrics. 1971 May;47(5):831–838. [PubMed] [Google Scholar]
  9. Lucas A., Gore S. M., Cole T. J., Bamford M. F., Dossetor J. F., Barr I., Dicarlo L., Cork S., Lucas P. J. Multicentre trial on feeding low birthweight infants: effects of diet on early growth. Arch Dis Child. 1984 Aug;59(8):722–730. doi: 10.1136/adc.59.8.722. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Pagliara A. S., Karl I. E., Haymond M., Kipnis D. M. Hypoglycemia in infancy and childhood. I. J Pediatr. 1973 Mar;82(3):365–379. doi: 10.1016/s0022-3476(73)80109-x. [DOI] [PubMed] [Google Scholar]
  11. Pildes R., Forbes A. E., O'Connor S. M., Cornblath M. The incidence of neonatal hypoglycemia--a completed survey. J Pediatr. 1967 Jan;70(1):76–80. doi: 10.1016/s0022-3476(67)80168-9. [DOI] [PubMed] [Google Scholar]
  12. SMALLPEICE V., DAVIES P. A. IMMEDIATE FEEDING OF PREMATURE INFANTS WITH UNDILUTED BREAST-MILK. Lancet. 1964 Dec 26;2(7374):1349–1352. doi: 10.1016/s0140-6736(64)91152-3. [DOI] [PubMed] [Google Scholar]
  13. Siegel L. S. Correction for prematurity and its consequences for the assessment of the very low birth weight infant. Child Dev. 1983 Oct;54(5):1176–1188. [PubMed] [Google Scholar]
  14. WYBREGT S. H., REISNER S. H., PATEL R. K., NELLHAUS G., CORNBLATH M. THE INCIDENCE OF NEONATAL HYPOGLYCEMIA IN A NURSERY FOR PREMATURE INFANTS. J Pediatr. 1964 Jun;64:796–802. doi: 10.1016/s0022-3476(64)80637-5. [DOI] [PubMed] [Google Scholar]

Articles from BMJ : British Medical Journal are provided here courtesy of BMJ Publishing Group

RESOURCES