Glycemia and Neonatal Encephalopathy: Outcomes in the LyTONEPAL (Long-Term Outcome of Neonatal Hypoxic EncePhALopathy in the Era of Neuroprotective Treatment With Hypothermia) Cohort - 17/06/23
Abstract |
Objectives |
To assess in newborns with neonatal encephalopathy (NE), presumptively related to a peripartum hypoxic–ischemic event, the frequency of dysglycemia and its association with neonatal adverse outcomes.
Study design |
We conducted a secondary analysis of LyTONEPAL (Long-Term Outcome of Neonatal hypoxic EncePhALopathy in the era of neuroprotective treatment with hypothermia), a population-based cohort study including 545 patients with moderate-to-severe NE. Newborns were categorized by the glycemia values assessed by routine clinical care during the first 3 days of life: normoglycemic (all glycemia measurements ranged from 2.2 to 8.3 mmol/L), hyperglycemic (at least 1 measurement >8.3 mmol/L), hypoglycemic (at least 1 measurement <2.2 mmol/L), or with glycemic lability (measurements included at least 1 episode of hypoglycemia and 1 episode of hyperglycemia). The primary adverse outcome was a composite outcome defined by death and/or brain lesions on magnetic resonance imaging, regardless of severity or location.
Results |
In total, 199 newborns were categorized as normoglycemic (36.5%), 74 hypoglycemic (13.6%), 213 hyperglycemic (39.1%), and 59 (10.8%) with glycemic lability, based on the 2593 glycemia measurements collected. The primary adverse outcome was observed in 77 (45.8%) normoglycemic newborns, 37 (59.7%) with hypoglycemia, 137 (67.5%) with hyperglycemia, and 40 (70.2%) with glycemic lability (P < .01). With the normoglycemic group as the reference, the aORs and 95% 95% CIs for the adverse outcome were significantly greater for the group with hyperglycemia (aOR 1.81; 95% CI 1.06-3.11).
Conclusions |
Dysglycemia affects nearly two-thirds of newborns with NE and is independently associated with a greater risk of mortality and/or brain lesions on magnetic resonance imaging.
Trial registration |
NCT02676063
Le texte complet de cet article est disponible en PDF.Keywords : neonatal mortality, brain lesions, magnetic resonance imaging, secondary cerebral insult, dysglycemia, neonatal encephalopathy, hypoxic-ischemic perinatal event
Abbreviations : LyTONEPAL, MRI, NE
Plan
Supported by 2013 French Program for Hospital Clinical Research (PHRC-N-13-0327). Newborn Safety Net foundation; Roualet Price. The funder had no role in the design and conduct of the study. The authors declare no conflicts of interest. |
Vol 257
Article 113350- juin 2023 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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