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Oral Concurrent Session 1 - Prematurity

Oral Concurrent Sessions

(19) Neonatal Hypoglycemia in Pregnancies at Risk for Late Preterm Birth: Childhood Neurodevelopmental Outcomes

Tuesday, February 13, 2024
2:00 PM – 2:15 PM  
Location: Potomac Ballroom AB, Ballroom Level
Objective: Persistent neonatal hypoglycemia is related to adverse neurodevelopment in infants born preterm, but it is unknown whether late preterm hypoglycemia, often transient and more frequent with maternal antenatal steroid treatment, is similarly related. Our objective was to evaluate whether hypoglycemia in neonates at risk for late preterm delivery was related to adverse childhood neurodevelopment.

Study Design: Secondary analysis of a prospective, follow-up study of ≥ 6 year-old children delivered in the NICHD Antenatal Late Preterm Steroids study, which excluded patients with pregestational diabetes.  Certified psychologists performed neurocognitive testing using the Differential Ability Scales, 2nd Edition (DAS-II) core components of general conceptual ability (GCA): verbal, non-verbal reasoning, and spatial ability. Hypoglycemia was defined as blood glucose concentration < 40 mg/dL within 24 hours of birth. Primary and secondary outcomes were compared in children with and without hypoglycemia and by severity: 25-39 mg/dL (moderate) and < 25 mg/dL (severe) vs none. The primary outcome was the proportion of GCA scores < 85 (-1 standard deviation) and secondary outcomes included the Gross Motor Function Classification System, Social Responsiveness Scale, and Child Behavior Checklist. Log-binomial regression was used to calculate relative risks (RR) and quantile regression and mixed linear models to estimate differences.

Results: Of 1,026 children enrolled, 1,020 (99.4%) had blood glucose data. 234 (22.9%) had hypoglycemia, 852 (83.5%) delivered late preterm and 97 (41.5%) with hypoglycemia were treated. Those with hypoglycemia were more likely to have private insurance, older mothers, received betamethasone, and identify as White. There were no differences in the primary, GCA score < 85 (15.9% vs 18.5%; aRR 1.03; 95% CI: 0.74, 1.45), or secondary outcomes. Severity of hypoglycemia was also not associated with primary or secondary outcomes.

Conclusion: Hypoglycemia was not associated with neurodevelopmental outcomes in children born predominantly late preterm.