Neurodevelopmental Outcome in Neonates with Hypoglycaemia and AssociatedRisk Factors: A Follow up Study

Abstract

Introduction: Neonatal hypoglycemia is a common problem requiring medical attention in newborn and a leading cause of preventable brain damage, physical and mental handicap and early deaths among infants. Objective: To study the prevalence of neuro-developmental abnormalities and risk factors associated with poor outcome. Materials and methods: This was a prospective study on 39 neonates with hypoglycemia who were admitted to neonatal intensive care unit (NICU) from November 2015 to December 2016 and were fulfilling the inclusion criteria. Gestational age at birth, sex, birth weight, age of presentation, duration and severity of hypoglycaemia were noted in all neonates. Neuro-developmental assessment was done on follow up at 3 and 6 months by Denver developmental screening test 2 (DDST 2) method. Results: Out of 39 neonates, the prevalence of abnormal neurodevelopmental outcome according to DDST II method was 71.7% [n=28] at 3 months and 66.6% [n=26] at 6 months. Factors such as early onset, symptoms, longer duration of hypoglycemia, minimum blood glucose level, number of readings <25 mg/dl and maximum glucose infusion rate (GIR) were significantly associated with adverse outcome. Conclusion: Neonatal hypoglycemia is associated with long-term neurodevelopmental handicaps. Mental and psychomotor developmental indices of the children who suffered from hypoglycemia during new-born period are significantly low. Hence, early diagnosis and treatment of neonatal hypoglycemia is mandatory to prevent neurological sequelae.