Endocrine Abstracts

Introduction: Neonatal hypoglycaemia (NH) is a well-recognized cause of adverse neurological outcomes. While hypoglycaemic brain injury is well reported in the literature there is limited data on the effect of neonatal hypoglycaemia solely with other risk factors for brain injury excluded. The aim of study was to evaluate the long-term outcome in patients with a history of symptomatic NH and no other risk factors of brain injury.

Methodology: This retrospective cohort study examined the outcome among children with history of symptomatic NH. The study looks at babies born from January 2008 and January 2014 admitted to the neonatal intensive care unit. A total 6411 new born infants were identified. 850/6411 were recorded as having NH on neonatal electronic database. 518/850 were excluded for a gestational age < 36 weeks. After further inclusive and exclusion criteria were applied to identify patients with solely NH as a risk factor for poor neurological outcome, 94/855 patients met study eligibility. Data for these patients was reviewed from variety sources including neonatal discharge summary, community assessments, ophthalmology, paediatric medical notes and laboratory results. 2/94 patients were found to have adverse neurological outcomes. These two cases are presented and analysed.

Results and conclusion: We identified 94 eligible children with neonatal hypoglycaemia and no other risk factors for brain injury. 2/94 (2.1%) patients had NH related brain injury and adverse neurological outcome- both children had history of neonatal seizures. The remaining 92/92 (97.8%) had favourable neurological outcome and no neonatal seizures.

Our study concludes that neonatal hypoglycaemia causes global brain injury and second, neonatal seizure is a significant predictor of the potential long-term poor outcomes of isolated NH. Education of the parents/carers and health professional remains an important strategy. Further research on the effect of NH and NH related seizure on long-term neurological outcomes in needed.