Neonatal hypoglycemia not associated with lower educational achievement in moderate to late preterm and term infants

Reference

Shah R, Dai DWT, Alsweiler JM, et al, for the Children With Hypoglycaemia and Their Later Development (CHYLD) Study Team. Association of neonatal hypoglycemia with academic performance in mid-childhood. JAMA 2022;327(12):1158-1170.

Synopsis

Previous studies of infants who experienced neonatal hypoglycemia report an increased risk of low executive function and visual-motor integration at 4.5 years of age. These investigators analyzed data from a prospective longitudinal cohort study in New Zealand of moderate to late preterm and term infants born from December 2006 to November 2010. Eligible infants (N = 587) included those born with at least 1 risk factor for neonatal hypoglycemia, including a mother with diabetes, less than 37 weeks' gestation, weight less than 10th percentile or less than 2500 g, and weight greater than 90th percentile or more than 4500 g. Hypoglycemia, defined as a blood glucose concentration of less than 47 mg/dL, was immediately treated with additional feeding, buccal dextrose gel, or intravenous dextrose as needed to maintain a blood glucose concentration at least 47 mg/dL. At 9 to 10 years' corrected age, children underwent an assessment by individuals unaware of the neonatal glycemic history. Complete follow-up occurred for 480 (82%) of eligible infants. Of these, neonatal hypoglycemia developed in 304 (63%) children, with 111 (37%) having at least 1 severe event (blood glucose concentration < 36 mg/dL) and 165 (54%) having severe recurrent events (hypoglycemia occurring at least 3 separate times more than 20 minutes apart). No significant association occurred between low educational achievement and exposure compared with no exposure to neonatal hypoglycemia. Similarly, no significant differences occurred between children experiencing different severities or frequencies of neonatal hypoglycemia.