Long duration of hyperglycemia in the first 96 hours of life is associated with severe intraventricular hemorrhage in preterm infants

Adi Auerbach, Smadar Eventov-Friedman, Ilan Arad, Ofra Peleg, Tali Bdolah-Abram, Benjamin Bar-Oz, David Haim Zangen*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

44 Scopus citations

Abstract

Objective: To assess the association between severe intraventricular hemorrhage (IVH) and blood glucose variables during the first 96 hours of life in preterm infants. Study design: Preterm infants with IVH grade 3-4 (n = 70) were compared with matched infants of similar gestational age and birth weight, but with no IVH (n = 108). Studied variables included the frequency and duration of hyper/hypoglycemic (>6.9/<3.3 mmol/L, respectively) events, the extreme slope of an event evolution, the maximal glucose value observed, and the "hyper/hypoglycemic index" representing a weighted average of the hyper/hypoglycemic amplitude. Results: The IVH group had significantly more hyperglycemic events (2.9 ± 1.7 vs 2.4 ± 1.8 events, P <.05) with longer duration (22.2 ± 14.2 vs 14.1 ± 12.5 hours, P <.001) and a higher hyperglycemic index (1.0±0.9 vs 1.4±1.0, P =.003) compared with the non-IVH controls. Respiratory distress syndrome, hypotension, and thrombocytopenia increased the adjusted OR for IVH. Hypoglycemia was not independently associated with IVH. Conversely, the increase in hyperglycemic duration was most prominently increasing the aOR for severe IVH (OR = 10.33, 95% CI = 10.0-10.6, P =.033). Conclusion: Longer duration of hyperglycemia in the first 96 hours of life was most strongly associated with severe IVH in preterm infants. Consequently, interventional studies to determine the selective effect of continuous control of long-lasting hyperglycemia by appropriate and timed insulin treatment on the incidence of severe IVH are warranted.

Original languageAmerican English
Pages (from-to)388-393
Number of pages6
JournalJournal of Pediatrics
Volume163
Issue number2
DOIs
StatePublished - Aug 2013
Externally publishedYes

Keywords

  • IVH
  • Intraventricular hemorrhage
  • NICU
  • Neonatal intensive care unit
  • PDA
  • Patent ductus arteriosus
  • RDS
  • Respiratory distress syndrome
  • US
  • Ultrasound

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