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Does hyperglycemia in hypernatremic preterm infants increase the risk of intraventricular hemorrhage?

J Bermick1, R E Dechert1, S Sarkar1

  • 1Division of Neonatal-Perinatal Medicine, C.S. Mott Children's Hospital, University of Michigan Health System, Ann Arbor, MI, USA.

Journal of Perinatology : Official Journal of the California Perinatal Association
|May 20, 2016
PubMed

Insights

Hyperglycemia and hypernatremia significantly increase the risk of intraventricular hemorrhage (IVH) in preterm infants. The combined presence of both conditions poses the greatest risk for IVH development in this vulnerable population.

Area of Science:

  • Neonatal Medicine
  • Pediatric Neurology
  • Clinical Biochemistry

Background:

  • Hypernatremia and hyperglycemia are common in preterm infants, potentially causing hyperosmolarity and osmotic shifts.
  • Intraventricular hemorrhage (IVH) is a serious complication in preterm neonates.

Purpose of the Study:

  • To investigate the relationship between hyperglycemia and the risk of IVH in preterm infants with hypernatremia.
  • To determine if hyperglycemia exacerbates IVH risk in the context of hypernatremia.

Main Methods:

  • Retrospective review of 216 preterm infants (<1000g birth weight, <29 weeks gestational age) over 9 years.
  • Serum sodium and blood glucose levels were monitored regularly.
  • Hyperglycemia defined as persistently high glucose (>200 mg/dL) treated with insulin; hypernatremia defined as serum sodium ≥150 mmol/L.

Main Results:

  • IVH occurred more frequently in infants with hyperglycemia (35%) and hypernatremia (58%).
  • The combined presence of hypernatremia and hyperglycemia showed a significantly higher incidence of IVH (P=0.001, OR 3.2).
  • Multivariate analysis confirmed independent association of IVH risk with combined hypernatremia and hyperglycemia (P=0.015).

Conclusions:

  • Hyperglycemia is associated with an increased risk of IVH in hypernatremic preterm infants.
  • The co-occurrence of hypernatremia and hyperglycemia presents a substantially elevated risk for IVH in this population.
Abstract

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