Long-term effects of neonatal hypoglycemia on brain growth and psychomotordevelopment in small-for-gestational-age preterm infants

Objective: To investigate the effects of neonatal hypoglycemia on physical growth and neurocognitive function. Study design: A systematic detection of hypoglycemia (<2.6 mmol/L or 47 mg/ dL) was carried out in 85 small-for-gestational-age preterm neonates. Prosp ective serial evaluations of physical growth and psychomotor development we re performed. Retrospectively, infants were grouped according to their glyc emic status. Results: The incidence of hypoglycemia was 72.9%. Infants with repeated epi sodes of hypoglycemia had significantly reduced head circumferences and low er scores in specific psychometric tests at 3.5 years of age. Hypoglycemia also caused reduced head circumferences at 18 months and lower psychometric scores at 5 years of age. Infants with moderate recurrent hypoglycemia had lower scores at 3.5 and 5 years of age compared with the group of infants who had 1 single severe hypoglycemic episode. Conclusion: Recurrent episodes of hypoglycemia were strongly correlated wit h persistent neurodevelopmental and physical growth deficits until 5 years of age. Recurrent hypoglycemia also was a more predictable factor for long- term effects than the severity of a single hypoglycemic episode. Therefore repetitive blood glucose monitoring and rapid treatment even for mild hypog lycemia are recommended for small-for-gestational-age infants in the neonat al period.