Factors influencing glycaemic stability after neonatal hypoglycaemia and relationship to neurodevelopmental outcome.

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dc.contributor.author Burakevych, Nataliia en
dc.contributor.author McKinlay, Christopher en
dc.contributor.author Harris, Deborah en
dc.contributor.author Alsweiler, Jane en
dc.contributor.author Harding, Jane en
dc.date.accessioned 2020-02-11T03:41:21Z en
dc.date.issued 2019-05-31 en
dc.identifier.citation Scientific reports 9(1):8132 31 May 2019 en
dc.identifier.issn 2045-2322 en
dc.identifier.uri http://hdl.handle.net/2292/49883 en
dc.description.abstract Higher and unstable glucose concentrations in the first 48 hours in neonates at risk of hypoglycaemia have been associated with neurosensory impairment. It is unclear what defines and contributes to instability. This was a prospective study of term and late preterm babies (N = 139) born at risk of neonatal hypoglycaemia who had interstitial glucose (IG) monitoring and ≥1 hypoglycaemic episode <48 hours after birth (blood glucose concentration <2.6 mmol/l [<47 mg/dl]). For 6-hour epochs after each hypoglycaemic episode, masked IG parameters (time to reach maximum IG concentration [hours]; range, average, maximum and minimum IG concentrations; proportion of IG measurements outside the central band of 3-4 mmol/l [54-72 md/dl]; and total duration [hours] of IG concentrations <2.6 mmol/l) were analysed in tertiles and related to: (i) glycaemic instability in the first 48 hours (defined as the proportion of blood glucose concentrations outside the central band in the first 48 hours); (ii) risk factors and treatment for each episode; and (iii) risk of neurosensory impairment at 4.5 years, or at 2 years if a child was not seen at 4.5 years. Glycaemic instability in the first 48 hours was related to IG instability after hypoglycaemia. Risk factors for hypoglycaemia were not related to IG parameters. Treatment with intravenous dextrose was associated with higher IG maximum and range, and lower minimum compared to treatment with dextrose gel plus breast milk, breast milk alone or formula alone. The risk of neurosensory impairment was increased with both shorter and longer time to reach maximum epoch IG (P = 0.04; lower tertile [0.4-2.2 hours] vs middle [2.3-4.2 hours] OR 3.10 [95% CI 1.03; 9.38]; higher tertile [4.3-6.0 hours] vs middle OR 3.07; [95% CI 1.01; 9.24]). Glycaemic response to hypoglycaemia contributes to overall glycaemic instability in newborns and is influenced by treatment. Slow or rapid recovery of hypoglycaemia appears to be associated with neurosensory impairment. en
dc.format.medium Electronic en
dc.language eng en
dc.relation.ispartofseries Scientific reports en
dc.rights Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated. Previously published items are made available in accordance with the copyright policy of the publisher. en
dc.rights.uri https://researchspace.auckland.ac.nz/docs/uoa-docs/rights.htm en
dc.rights.uri https://creativecommons.org/licenses/by/4.0/ en
dc.title Factors influencing glycaemic stability after neonatal hypoglycaemia and relationship to neurodevelopmental outcome. en
dc.type Journal Article en
dc.identifier.doi 10.1038/s41598-019-44609-1 en
pubs.issue 1 en
pubs.begin-page 8132 en
pubs.volume 9 en
dc.rights.holder Copyright: The authors en
pubs.publication-status Published en
dc.rights.accessrights http://purl.org/eprint/accessRights/OpenAccess en
pubs.subtype Research Support, Non-U.S. Gov't en
pubs.subtype research-article en
pubs.subtype Journal Article en
pubs.subtype Research Support, N.I.H., Extramural en
pubs.elements-id 774431 en
pubs.org-id Liggins Institute en
pubs.org-id LiFePATH en
pubs.org-id Medical and Health Sciences en
pubs.org-id School of Medicine en
pubs.org-id Paediatrics Child & Youth Hlth en
dc.identifier.eissn 2045-2322 en
pubs.record-created-at-source-date 2019-06-01 en
pubs.dimensions-id 31148566 en

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