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Early Transient Hypoglycemia and Test Performance in At-Risk Newborns.

Nahed O ElHassan1, Eric W Schaefer2, Basilia Gonzalez3

  • 1Department of Pediatrics (Neonatal-Perinatal Medicine), University of Arkansas for Medical Sciences, Arkansas Children's Hospital, Little Rock, Arkansas.

American Journal of Perinatology
|July 31, 2021
PubMed
Summary

Early transient neonatal hypoglycemia (TNH) in at-risk infants is linked to lower literacy achievement in 4th grade. The number or type of risk factors did not alter this association, highlighting TNH as a key factor in academic performance.

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Area of Science:

  • Neonatal Medicine
  • Developmental Pediatrics
  • Pediatric Neurology

Background:

  • Transient neonatal hypoglycemia (TNH) affects at-risk infants, including preterm, small/large for gestational age, and infants of diabetic mothers (IDMs).
  • The long-term neurodevelopmental impact of early TNH, particularly on academic performance, requires further investigation.

Purpose of the Study:

  • To determine if early TNH (within 3 hours of birth) is associated with academic performance in at-risk infants.
  • To explore the influence of risk factor categories and numbers on this association.

Main Methods:

  • Retrospective cohort study of infants born in 1998-1999 with at least one recorded glucose concentration.
  • Defined TNH using glucose cutoffs (<35, <40, <45 mg/dL) and assessed 4th-grade literacy and mathematics proficiency.
  • Used logistic regression to analyze the association between early TNH and academic proficiency, controlling for perinatal factors.

Main Results:

  • Early TNH occurred in 6.3% to 20.5% of infants, increasing with multiple risk factors.
  • TNH (using <35 and <40 mg/dL cutoffs) was significantly associated with lower literacy proficiency.
  • No significant association was found between TNH and mathematics proficiency.
  • The category or number of risk factors did not impact academic proficiency.

Conclusions:

  • Early TNH in at-risk infants is associated with lower adjusted probability of 4th-grade literacy proficiency.
  • The impact of early TNH on academic outcomes was consistent regardless of the infant's risk factor category or number.