Mohammad Kazem Sabzehei1, Seyyed Abolfazl Afjeh2, Marjan Shakiba3, Parinaz Alizadeh4, Ahmad Reza Shamshiri5, Fatemeh Esmaili6. 1. Hamedan University of Medical Sciences, Hamedan, I.R. Iran. a_afjeh@sbmu.ac.ir. 2. 1)Pediatric Infections Research Center, Shahid Beheshti University of Medical Sciences, Tehran, I.R. Iran. 3)Mahdieh Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, I.R. Iran. 3. Mofid Children Hospital, Shahid Beheshti University of Medical Sciences, Tehran, I.R. Iran. 4. Mofid Cchildren Hospital, Shahid Beheshti University of Medical Sciences, Tehran, I.R. Iran. 5. Dental Research Center, Dentistry Research Institute, Department of Community Oral Health, School of Dentistry, Tehran University of Medical Sciences, Tehran, I.R. Iran. 6. Mahdieh Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, I.R. Iran.
Abstract
BACKGROUND: Neonatal hyperglycemia, which is relatively common in very low birth weight (VLBW) infants, is associated with increased risk of morbidity and mortality. OBJECTIVE: To study the incidence of neonatal hyperglycemia, associated risk factors and the outcome of it in VLBW infants hospitalized in a level III NICU in Tehran. METHODS: All VLBW newborns admitted to the NICU of Mahdieh Hospital from April 2009 to March 2011 were considered eligible for this retrospective study. All relevant prenatal and perinatal data, as well as details of the hospital stay until discharge or death, were extracted from the case notes and analyzed. RESULTS: Hyperglycemia (blood suger above 150 mg/dL) was observed in 179 (31.7%) of the 564 VLBW infants included in the study; 48 infants (26.8%), had received insulin. Risk factors included: low gestational age, (OR = 4.07, 95% CI = 2.09-7.93, P < 0.001), extremely low birth weight (ELBW) , (OR = 5.97, 95% CI = 3.77-9.44, P < 0.001), dopamine administration (OR = 2.19, 95% CI = 1.32-3.65, P = 0.003), intralipid (OR = 1.52, 95% CI = 1.04-2.22, P = 0.03), Low APGAR score at 5 minutes (OR = 4.44, 95% CI = 2.48-7.94, P < 0.001), RDS and its complications (OR = 4.20, 95% CI = 2.55-6.93, P < 0.001), were independently associated with hyperglycemia. Other findings with hyperglycemia were: high incidence of IVH >grade II (OR = 2.88, 95% CI = 1.28-6.49, P = 0.01), hospital stay more than 28 days in survivors,(OR = 3.56, 95% CI = 2.02-6.25, P < 0.001), mortality (OR = 4.42, 95% CI = 3.00-6.52, P < 0.001) and more retinopathy of prematurity (ROP ≥ stage II) in survivors (OR = 2.05, 95% CI = 1.11-3.78, P = 0.02). CONCLUSION: Neonatal hyperglycemia developed in approximately one-third of our VLBW neonates. Relative prevalence and associated findings underscore the need for preventive measures and prompt management.
BACKGROUND:Neonatal hyperglycemia, which is relatively common in very low birth weight (VLBW) infants, is associated with increased risk of morbidity and mortality. OBJECTIVE: To study the incidence of neonatal hyperglycemia, associated risk factors and the outcome of it in VLBW infants hospitalized in a level III NICU in Tehran. METHODS: All VLBW newborns admitted to the NICU of Mahdieh Hospital from April 2009 to March 2011 were considered eligible for this retrospective study. All relevant prenatal and perinatal data, as well as details of the hospital stay until discharge or death, were extracted from the case notes and analyzed. RESULTS:Hyperglycemia (blood suger above 150 mg/dL) was observed in 179 (31.7%) of the 564 VLBW infants included in the study; 48 infants (26.8%), had received insulin. Risk factors included: low gestational age, (OR = 4.07, 95% CI = 2.09-7.93, P < 0.001), extremely low birth weight (ELBW) , (OR = 5.97, 95% CI = 3.77-9.44, P < 0.001), dopamine administration (OR = 2.19, 95% CI = 1.32-3.65, P = 0.003), intralipid (OR = 1.52, 95% CI = 1.04-2.22, P = 0.03), Low APGAR score at 5 minutes (OR = 4.44, 95% CI = 2.48-7.94, P < 0.001), RDS and its complications (OR = 4.20, 95% CI = 2.55-6.93, P < 0.001), were independently associated with hyperglycemia. Other findings with hyperglycemia were: high incidence of IVH >grade II (OR = 2.88, 95% CI = 1.28-6.49, P = 0.01), hospital stay more than 28 days in survivors,(OR = 3.56, 95% CI = 2.02-6.25, P < 0.001), mortality (OR = 4.42, 95% CI = 3.00-6.52, P < 0.001) and more retinopathy of prematurity (ROP ≥ stage II) in survivors (OR = 2.05, 95% CI = 1.11-3.78, P = 0.02). CONCLUSION:Neonatal hyperglycemia developed in approximately one-third of our VLBW neonates. Relative prevalence and associated findings underscore the need for preventive measures and prompt management.
Authors: Sang Jin Kim; Alexander D Port; Ryan Swan; J Peter Campbell; R V Paul Chan; Michael F Chiang Journal: Surv Ophthalmol Date: 2018-04-19 Impact factor: 6.048