Babies who are born prematurely and who suffer from hypoglycemia, or low blood sugar, after birth are at an increased risk for developmental delays, says a new study published in the August 2012 issue of the journal Pediatrics.
That premature babies who are born between 32 and 35 weeks of gestation are at an increased risk for both neonatal morbidities and developmental delays in early childhood is widely known. However, what was previously unknown was whether the occurrence of neonatal complications such as hypoglycemia increased the risk for developmental delays during childhood.
In the present study published as “Neonatal Morbidities and Developmental Delay in Moderately Preterm-Born Children”, researchers from the Division of Neonatology at the Beatrix Children’s Hospital at University Medical Center Groningen in The Netherlands sought to determine the effect of neonatal health complications including hypoglycemia on the development at preschool age of children who were born prematurely.
The researchers looked at data on 832 moderately preterm children born between 2002 and 2003. The data examined included
Apgar scores, asphyxia, tertiary NICU admission, hospital transfer, circulatory insufﬁciency, hypoglycemia, septicemia, mechanical ventilation, continuous positive airway pressure, apneas, caffeine treatment, and hyperbilirubinemia, all of which was obtained from medical records. When the children were between 43 to 49 months old, their development was assessed. The researchers also controlled for compounding factors such as gender, small-for-gestational-age status, gestational age, and maternal education.
According to the study, hypoglycemia and asphyxia were the only two neonatal complications associated with developmental delays, and only hypoglycemia was associated with an increased risk for developmental delays during childhood. In other words, premature babies who suffer from low blood sugar after birth are more likely to suffer from development delays as children.
The the risk of developmental delay increased from 9.1% to almost 20% among premature babies with hypoglycemia.
The reason for the increased risk for developmental delays as a result of hypoglycemia is that low blood sugar can lead to brain injury. Additionally, the risk for hypoglycemia is increased among moderately premature babies because, in comparison with healthy full term, babies born prematurely have fewer glucose stores, less alternative substrates, and less well-developed hormonal counter-regulatory mechanisms to sustain adequate glucose levels after birth.
The results of this study are important for the management of low blood sugar among premature babies. As the researchers conclude:
“Hypoglycemia after moderately-preterm birth is associated with an increased risk of parent-reported developmental delay at age 4. Stricter monitoring and timely treatment of hypoglycemia after birth might beneﬁt the large group of moderately preterm-born children.”
Hypoglycemia can be better managed through regular glucose monitoring during the ﬁrst 24 hours and administering early, frequent enteral feedings.