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Hyperglycemia is a risk factor for early death and morbidity in extremely low birth-weight infants

Stephane P Hays1, E O'Brian Smith, Agneta L Sunehag

  • 1USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, 1100 Bates St, Houston, TX 77030, USA.

Pediatrics
|November 3, 2006
PubMed

Insights

Hyperglycemia is common in extremely low birth-weight infants and increases risks for death, severe brain bleeds, and longer hospital stays. Managing blood glucose may improve outcomes for these vulnerable infants.

Area of Science:

  • Neonatalogy
  • Pediatric Endocrinology
  • Clinical Research

Background:

  • Extremely low birth-weight (ELBW) infants often experience metabolic disturbances.
  • Hyperglycemia is a frequent complication in parenterally fed ELBW infants.
  • The impact of hyperglycemia on adverse outcomes in ELBW infants requires further elucidation.

Purpose of the Study:

  • To determine the prevalence of hyperglycemia in ELBW infants.
  • To investigate if hyperglycemia elevates the risk of early adverse outcomes (death or severe intraventricular hemorrhage).
  • To assess the effect of hyperglycemia on hospital stay duration in survivors without severe intraventricular hemorrhage.

Main Methods:

  • Retrospective chart review of 93 ELBW infants admitted in 2001.
  • Averaged key physiological parameters (blood glucose, dopamine, oxygen, sodium) during the first week of life or until adverse events.
  • Calculated time ratio for blood glucose >150 mg/dL in survivors without severe intraventricular hemorrhage.

Main Results:

  • Over 50% of ELBW infants exhibited persistent hyperglycemia (>150 mg/dL) in the first week.
  • Higher average blood glucose concentrations correlated with adverse outcomes, interacting with Clinical Risk Index for Babies score and inspired oxygen levels.
  • Increased hospital stay duration was linked to hyperglycemia duration, interacting with birth weight and inspired oxygen levels.

Conclusions:

  • Confirms high prevalence of hyperglycemia in parenterally fed ELBW infants.
  • Elevated blood glucose levels are associated with increased risk of early mortality, severe intraventricular hemorrhage, and prolonged hospitalization.
  • Suggests that hyperglycemia prevention and management could significantly improve outcomes for ELBW infants.
Abstract

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