High glucose variability is associated with poor neurodevelopmental outcomes in neonatal hypoxic ischemic encephalopathy

N. Al Shafouri, M. Narvey, G. Srinivasan, J. Vallance, G. Hansen

Research output: Contribution to journalJournal Articlepeer-review

27 Citations (Scopus)


BACKGROUND: In neonatal hypoxic ischemic encephalopathy (HIE), hypo-and hyperglycemia have been associated with poor outcomes. However, glucose variability has not been reported in this population. OBJECTIVE: To examine the association between serum glucose variability within the first 24 hours and two-year neurodevelopmental outcomes in neonates cooled for HIE. STUDY DESIGN: In this retrospective cohort study, glucose, clinical and demographic data were documented from 23 term newborns treated with whole body therapeutic hypothermia. Severe neurodevelopmental outcomes from planned two-year assessments were defined as the presence of any one of the following: Gross Motor Function Classification System levels 3 to 5, Bayley III Motor Standard Score <70, Bayley III Language Score <70 and Bayley III Cognitive Standard Score <70. RESULTS: The neurodevelopmental outcomes from 8 of 23 patients were considered severe, and this group demonstrated a significant increase of mean absolute glucose (MAG) change (-0.28 to-0.03, 95% CI, p = 0.032). There were no significant differences between outcome groups with regards to number of patients with hyperglycemic means, one or multiple hypo-or hyperglycemic measurement(s). There were also no differences between both groups with mean glucose, although mean glucose standard deviation was approaching significance. CONCLUSIONS: Poor neurodevelopmental outcomes in whole body cooled HIE neonates are significantly associated with MAG changes. This information may be relevant for prognostication and potential management strategies.

Original languageEnglish
Pages (from-to)119-124
Number of pages6
JournalJournal of Neonatal-Perinatal Medicine
Issue number2
Publication statusPublished - 31 Jul. 2015


  • Neonatal
  • glucose
  • hypothermia
  • hypoxic ischemic encephalopathy
  • treatment outcomes


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