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Updated: Jan 25, 2026
Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Follow-up study of neurodevelopment in 2-year-old infants who had suffered from neonatal hypoglycemia
Lin-Xia Qiao1,2, Jian Wang3, Ju-Hua Yan3
1Department of Neonatology, Children's Hospital of Soochow University, No. 92 Zhongnan Street, Suzhou, 215025, Jiangsu, China.
Insights
Neonatal hypoglycemia, particularly when prolonged, impairs infant adaptability. Maternal insulin use and excessive weight gain are linked to severe or persistent hypoglycemia in newborns.
Area of Science:
- Neonatalogy
- Pediatric Neurology
- Endocrinology
Background:
- Neonatal hypoglycemia is a significant risk factor for adverse neurodevelopmental outcomes and brain injury.
- Infants born to diabetic mothers are particularly susceptible to hypoglycemia.
Purpose of the Study:
- To investigate the long-term neurodevelopmental effects of neonatal hypoglycemia in infants born to diabetic mothers.
- To identify risk factors associated with severe or persistent neonatal hypoglycemia.
Main Methods:
- A prospective cohort study involving 195 infants of diabetic mothers with confirmed neonatal hypoglycemia (blood glucose < 2.6 mM).
- Infants were categorized into three groups based on the timing of hypoglycemia: A1 (<2h), A2 (2-24h), and A3 (>24h).
- A control group of 144 infants from non-diabetic mothers was included; neurodevelopment was assessed using the Gesell scoring method.
Main Results:
- Infants in subgroups A2 and A3 exhibited significantly lower adaptability scores compared to the control group.
- Maternal insulin use during the perinatal period was significantly higher in subgroup A3 compared to A1 and A2.
- Mothers of infants in subgroups A2 and A3 had significantly greater weight gain during pregnancy compared to the control group.
Conclusions:
- Prolonged and repeated neonatal hypoglycemia is associated with poor neurodevelopmental adaptability.
- Maternal factors such as insulin use and excessive weight gain during pregnancy are risk factors for severe or persistent neonatal hypoglycemia.
Background:
Neonatal hypoglycemia is tightly related to adverse neurodevelopmental and brain injury outcomes.
Methods:
A total of 195 infants who were born from diabetic mothers with a low blood glucose level (< 2.6 mM) within 0.5 h after birth were enrolled in this prospective cohort study. Of these, 157 infants who had neonatal hypoglycemia (group A) were followed up, and this group was further divided into A1 [blood glucose concentration (BGC) < 2.6 mM at < 2 h after birth], A2 (BGC < 2.6 mM at 2-24 h after birth), and A3 (BGC < 2.6 mM at > 24 h after birth). A total of 144 infants whose mothers had no high risk for gestational diabetes mellitus were followed up as the control group during the same period. The neurodevelopment of the infants was evaluated by the Gesell scoring method.
Results:
The adaptability in the A2 and A3 subgroups was significantly lower than that in the control group (73.9 ± 6.6 vs. 87.9 ± 11.2; 71.5 ± 8.9 vs. 87.9 ± 11.2, respectively). There were significantly more mothers who used insulin during the perinatal period in A3 than in A1 and A2 (31% vs. 2%; 31% vs. 7.9%, respectively). The mothers of babies in subgroups A2 and A3 gained more weight than those of the control group (15.3 ± 1.9 kg vs. 11.1 ± 2.2 kg; 14.8 ± 2.6 kg vs. 11.1 ± 2.2 kg, respectively).
Conclusions:
Long and repeated neonatal hypoglycemia caused poor adaptability. The babies of mothers who used insulin or had a high weight gain during pregnancy were associated with severe or persistent neonatal hypoglycemia.
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