Table 4. Primary and Prespecified Critical Secondary Outcomes in Mid-Childhood by Severity of Neonatal Hypoglycemia.
| Outcomes | Hypoglycemic eventsa | Adjusted risk difference, %, or mean difference (95% CI)b | Adjusted risk ratio or count ratio (95% CI)b | ||||
|---|---|---|---|---|---|---|---|
| None | Mild | Severe or recurrent | Mild vs none | Severe or recurrent vs none | Mild vs none | Severe or recurrent vs none | |
| Low educational achievement (primary outcome), No./total (%)c | 82/172 (48) | 40/103 (39) | 98/193 (51) | −9 (−23 to 5) | 2 (−9 to 13) | 0.85 (0.62 to 1.17) | 0.99 (0.79 to 1.25) |
| e-asTTle achievement z score in reading comprehension/Pānui, mean (SD)d | −0.32 (1.26) [n = 172] | −0.02 (1.08) [n =103] | −0.31 (1.11) [n =193] | 0.27 (−0.03 to 0.58) | 0.04 (−0.22 to 0.30) | ||
| e-asTTle achievement z score in mathematics/Pāngarau, mean (SD)d | −0.21 (0.78) [n = 171] | −0.10 (0.87) [n = 102] | −0.15 (0.82) [n = 193] | 0.08 (−0.14 to 0.30) | 0.09 (−0.10 to 0.27) | ||
| Need for additional learning support, older than expected for year level, or low educational achievement, No./total (%)e | 120/174 (69) | 72/106 (68) | 140/197 (71) | −1 (−19 to 10) | 2 (−9 to 12) | 0.98 (0.82 to 1.18) | 1.02 (0.88 to 1.19) |
| CANTAB One-Touch Stockings of Cambridge (planning/working memory)f | n = 173 | n = 104 | n = 195 | ||||
| Problems solved on first choice, median (IQR) | 8 (5-10) | 8 (6-10) | 8 (5-10) | 1.01 (0.91 to 1.11) | 1.00 (0.91 to 1.08) | ||
| Latency to first choice, mean (SD), ms | 13 604 (7632) | 12 521 (6161) | 12 505 (6788) | −1133 (−3047 to 782) | −1023 (−2641 to 596) | −1133 (−3047 to 782) | −1023 (−2641 to 596) |
| MABC-2 fine motor subtest score <15th percentile, No./total (%)g | 75/171 (44) | 41/104 (39) | 89/195 (46) | −0.01 (−0.13 to 0.11) | 0.02 (−0.09 to 0.13) | 0.93 (0.69 to 1.25) | 1.05 (0.83 to 1.33) |
| BBVMI-6 score <85, No./total (%)h | 71/173 (41) | 33/104 (32) | 76/195 (39) | −25 (−62 to 13) | −6 (−34 to 22) | 0.78 (0.54 to 1.13) | 0.94 (0.71 to 1.24) |
| Borderline or abnormal total difficulties score on parent- or teacher-rated SDQ, No./total (%)i | 68/173 (39) | 37/102 (36) | 85/193 (44) | 0 (−14 to 12) | 6 (−5 to 17) | 1.02 (0.71 to 1.45) | 1.13 (0.86 to 1.48) |
| AQ-Child total score, mean (SD)j | 54.5 (15.9) [n = 128] | 51.9 (15.8) [n = 82] | 55.7 (17.9) [n = 154] | −1.8 (−6.8 to 3.3) | 1.3 (−3.0 to 5.5) | ||
Abbreviation: e-asTTle, Electronic Assessment Tools for Teaching and Learning.
Hypoglycemic event is defined as the sum of nonconcurrent hypoglycemic and interstitial episodes more than 20 minutes apart; a hypoglycemic episode is defined as ≥1 consecutive blood glucose concentration <47 mg/dL (<2.6 mmol/L) and an interstitial episode as a sensor glucose concentration <47 mg/dL for ≥10 minutes. A severe event represents a blood or sensor glucose concentration <2.0 mmol/L.
Adjusted for potential confounding by sex, primary risk factor for hypoglycemia, and New Zealand Deprivation Index at study entry.
Low educational achievement is defined as an e-asTTle score below or well below the normative curriculum level in reading comprehension/Pānui or mathematics/Pāngarau.
Achievement z score is the standardized e-asTTle score for the current term of schooling.
Older than expected for year level was defined as a child being 1 or more years older than 95% of children in their year level on July 1 of the year in which they were assessed; ie, being aged 9 years or older in year 4, 10 years or older in year 5, or 11 years or older in year 6.
The Cambridge Neuropsychological Test Automated Battery (CANTAB) One-Touch Stockings of Cambridge test assesses working memory and planning, a key executive function capacity. Greater number of problems solved (maximum, 20) and shorter latency indicate better working memory and planning; for continuous data; count ratios of ≤0.80 or ≥1.20 or mean differences in latency by 0.3 SD are considered clinically significant (see eTable 1 in Supplement 3 for further details).
The fine motor subtest of the Movement Assessment Battery for Children, Second Edition (MABC-2) consists of 3 tests of manual dexterity: placing 12 pegs, threading a lace, and drawing a trail (normative mean score, 10 [SD, 3]).
The Beery-Buktenica Developmental Test of Visual-Motor Integration, Sixth Edition (BBVMI-6) assesses integration and visual perception and coordination. Lower scores indicate worse visual-motor function.
The Strengths and Difficulties Questionnaire (SDQ) assesses emotional symptoms, conduct problems, hyperactivity/inattention, peer relationships, and prosocial behavior. A higher total difficulties score indicates worse emotional and behavioral regulation.
The Autism Spectrum Quotient: Children’s Version (AQ-Child) assesses autism spectrum disorder traits. A higher total score indicates greater autism traits; the mean in 4- to 11-year-old children is 41.7 (SD, 18.6), with a possible range of 0 to 150.26