Original ArticleHypoglycemia is Associated with Increased Risk for Brain Injury and Adverse Neurodevelopmental Outcome in Neonates at Risk for Encephalopathy
Section snippets
Methods
Term neonates born between 1994 and 2010 at the University of California San Francisco (UCSF) at risk for neonatal encephalopathy were included in this prospective cohort study. Inclusion criteria include an umbilical artery pH <7.1, umbilical artery base deficit >10, or a 5-minute Apgar score ≤5. Newborns were excluded if their gestational age at birth was <36 weeks or there were suspected or confirmed congenital malformations, inborn errors of metabolism, or congenital infections based on
Results
A total of 94 subjects were enrolled during the period of 1994-2010. Hypoglycemia was detected in the first 24 hours after birth in 15 (16%) of the 94 subjects. The clinical demographics of this cohort separated into children with and without hypoglycemia detected in the first 24 hours after birth (Table I). Newborns with hypoglycemia demonstrated higher encephalopathy scores in the first 24 hours after birth and had a higher rate of neonatal seizures during the hospital course. Umbilical
Discussion
In this cohort study of MRI after neonatal encephalopathy, an independent association was found between hypoglycemia in the first 24 hours after birth and increased risk of injury to the corticospinal tract. The classic parieto-occipital pattern of brain injury after isolated neonatal hypoglycemia was not observed. In addition, associations were found between hypoglycemia in the first 24 hours after birth and motor and cognitive impairment at 1-year follow-up.
Recent literature suggests a
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2022, Veterinary Clinics of North America - Equine PracticeCitation Excerpt :Given the importance of neuronal energy failure in the pathophysiology of some forms of NE, maintaining blood glucose is of particular importance in affected foals. The evidence for the effects of abnormal glucose concentrations in NE in other species is conflicting, with both hypo- and hyperglycemia associated with worse outcomes.50–52 In human infants hyperglycemia was temporally associated with increased frequency of seizures.53
This article was supported by the National Institutes of Health (grants 5R13 NS040925, P50 NS35902, UL1 RR024131, NINDS 1K23NS066137 [to H.G.]). E.T. is a Cerebral Palsy International Research Foundation Ethel & Jack Hausman Clinical Research Scholar. The authors declare no conflicts of interest.
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Contributed equally to the study.