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Long-Term Outcomes of Hyperglycemic Preterm Infants Randomized to Tight Glycemic Control.
- Source :
- Journal of Pediatrics; Feb2018, Vol. 193, p68-75.e1, 1p
- Publication Year :
- 2018
-
Abstract
- <bold>Objective: </bold>To determine whether tight glycemic control of neonatal hyperglycemia changes neurodevelopment, growth, and metabolism at school age.<bold>Study Design: </bold>Children born very low birth weight and randomized as hyperglycemic neonates to a trial of tight vs standard glycemic control were assessed at 7 years corrected age, including Wechsler Intelligence Scale for Children Fourth Edition, Movement Assessment Battery for Children 2, visual and neurologic examinations, growth measures, dual X-ray absorptiometry, and frequently sampled intravenous glucose tolerance test. The primary outcome was survival without neurodevelopmental impairment at age 7 years. Outcomes were compared using linear regression, adjusted for sex, small for gestational age, birth plurality, and the clustering of twins. Data are reported as number (%) or mean (SD).<bold>Results: </bold>Of the 88 infants randomized, 11 (13%) had died and 57 (74% of eligible children) were assessed at corrected age 7 years. Survival without neurodevelopmental impairment occurred in 25 of 68 children (37%), with no significant difference between tight (14 of 35; 40%) and standard (11 of 33; 33%) glycemic control groups (P = .60). Children in the tight group were shorter than those in the standard group (121.3 [6.3] cm vs 125.1 [5.4] cm; P < .05), but had similar weight and head circumference. Children in the tight group had greater height-adjusted lean mass (18.7 [0.3] vs 17.6 [0.2] kg; P < .01) and lower fasting glucose concentrations (84.6 [6.30] vs 90.0 [5.6] mg⋅dL-1; P < .05), but no other differences in measures of body composition or insulin-glucose metabolism.<bold>Conclusion: </bold>Tight glycemic control for neonatal hyperglycemia does not change survival without neurodevelopmental impairment, but reduces height, increases height-adjusted lean mass, and reduces fasting blood glucose concentrations at school age.<bold>Trial Registration: </bold>ACTRN: 12606000270516. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 00223476
- Volume :
- 193
- Database :
- Supplemental Index
- Journal :
- Journal of Pediatrics
- Publication Type :
- Academic Journal
- Accession number :
- 127284453
- Full Text :
- https://doi.org/10.1016/j.jpeds.2017.09.081