Effect of glucose metabolism disorders on the short-term prognosis in neonates with asphyxia: a multicenter study in Hubei Province, China

LIU Chun-Hua; WANG Hui; PENG Si-Cong; WANG Wen-Xiang; JIAO Rong; PAN Sha; ZHU Tian-Jiao; LUAN Xiao-Ying; ZHU Xiao-Fang; WU Su-Ying; WEI De-Guo; FU Bing-Feng; YAN Rui-Hong; YANG Shu-Jie; LUO Ya-Hui; LI Gui-Ping; YANG Min; JIA De-Zhao; GAO Chuang; XIAO Xiong-Fei; XIONG Li; SUN Jie; XIAO Jia-Peng; LI Bo-Wen; LI Yan-Ni; ZHANG Lian-Hong; LI Tian-Guo; CHENG Min; XIA Jian-Xin; XIA Shi-Wen

doi:10.7499/j.issn.1008-8830.2108188

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Chinese Journal of Contemporary Pediatrics ›› 2021, Vol. 23 ›› Issue (12) : 1208-1213. DOI: 10.7499/j.issn.1008-8830.2108188

CLINICAL RESEARCH

Effect of glucose metabolism disorders on the short-term prognosis in neonates with asphyxia: a multicenter study in Hubei Province, China

LIU Chun-Hua, WANG Hui, PENG Si-Cong, WANG Wen-Xiang, JIAO Rong, PAN Sha, ZHU Tian-Jiao, LUAN Xiao-Ying, ZHU Xiao-Fang, WU Su-Ying, WEI De-Guo, FU Bing-Feng, YAN Rui-Hong, YANG Shu-Jie, LUO Ya-Hui, LI Gui-Ping, YANG Min, JIA De-Zhao, GAO Chuang, XIAO Xiong-Fei, XIONG Li, SUN Jie, XIAO Jia-Peng, LI Bo-Wen, LI Yan-Ni, ZHANG Lian-Hong, LI Tian-Guo, CHENG Min, XIA Jian-Xin, XIA Shi-Wen

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Objective To study the effect of glucose metabolism disorders on the short-term prognosis in neonates with asphyxia. Methods A retrospective analysis was performed on the medical data of the neonates with asphyxia who were admitted to 52 hospitals in Hubei Province of China from January to December, 2018 and had blood glucose data within 12 hours after birth. Their blood glucose data at 1, 2, 6, and 12 hours after birth (with an allowable time error of 0.5 hour) were recorded. According to the presence or absence of brain injury and/or death during hospitalization, the neonates were divided into a poor prognosis group with 693 neonates and a good prognosis group with 779 neonates. The two groups were compared in the incidence of glucose metabolism disorders within 12 hours after birth and short-term prognosis. Results Compared with the good prognosis group, the poor prognosis group had a significantly higher proportion of neonates from secondary hospitals (48.5% vs 42.6%, P<0.05) or with severe asphyxia (19.8% vs 8.1%, P<0.05) or hypothermia therapy (4.8% vs 1.5%, P<0.05), as well as a significantly higher incidence rate of disorder of glucose metabolism (18.8% vs 12.5%, P<0.05). Compared with the good prognosis group, the poor prognosis group had a significantly higher incidence rate of disorder of glucose metabolism at 1, 2, and 6 hours after birth (P<0.05). The multivariate logistic regression analysis showed that recurrent hyperglycemia (adjusted odds ratio=2.380, 95% confidence interval: 1.275-4.442, P<0.05) was an independent risk factor for poor prognosis in neonates with asphyxia. Conclusions Recurrent hyperglycemia in neonates with asphyxia may suggest poor short-term prognosis, and it is necessary to strengthen the early monitoring and management of the nervous system in such neonates.

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Asphyxia / Hyperglycemia / Prognosis / Neonate

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LIU Chun-Hua, WANG Hui, PENG Si-Cong, WANG Wen-Xiang, JIAO Rong, PAN Sha, ZHU Tian-Jiao, LUAN Xiao-Ying, ZHU Xiao-Fang, WU Su-Ying, WEI De-Guo, FU Bing-Feng, YAN Rui-Hong, YANG Shu-Jie, LUO Ya-Hui, LI Gui-Ping, YANG Min, JIA De-Zhao, GAO Chuang, XIAO Xiong-Fei, XIONG Li, SUN Jie, XIAO Jia-Peng, LI Bo-Wen, LI Yan-Ni, ZHANG Lian-Hong, LI Tian-Guo, CHENG Min, XIA Jian-Xin, XIA Shi-Wen. Effect of glucose metabolism disorders on the short-term prognosis in neonates with asphyxia: a multicenter study in Hubei Province, China[J]. Chinese Journal of Contemporary Pediatrics. 2021, 23(12): 1208-1213 https://doi.org/10.7499/j.issn.1008-8830.2108188

References

1 徐韬, 岳青, 王惠珊, 等. 第二周期中国新生儿复苏项目实施效果评价[J]. 中华围产医学杂志, 2017, 20(5): 346-351. DOI: 10.3760/cma.j.issn.1007-9408.2017.05.009.
2 Odd D, Heep A, Luyt K, et al. Hypoxic-ischemic brain injury: planned delivery before intrapartum events[J]. J Neonatal Perinatal Med, 2017, 10(4): 347-353. PMID: 29286930. DOI: 10.3233/NPM-16152.
3 Cloherty JP, Eichenwald EC, Hansen AR, et al. Manual of neonatal care[M]. 7th ed. Philadelphia: Lippincott Williams & Wilkins, 2011: 711-728.
4 Qiao J, Wang YY, Li XH, et al. A lancet commission on 70 years of women's reproductive, maternal, newborn, child, and adolescent health in China[J]. Lancet, 2021, 397(10293): 2497-2536. PMID: 34043953. DOI: 10.1016/S0140-6736(20)32708-2.
5 张红琴, 黄璐, 陈俊, 等. 宫内窘迫新生儿生后早期外周血pH值与振幅整合脑电图结果的关系[J]. 中国当代儿科杂志, 2019, 21(5): 454-457. PMID: 31104662. PMCID: PMC7389430. DOI: 10.7499/j.issn.1008-8830.2019.05.011.
6 中国医师协会新生儿科医师分会. 新生儿缺氧缺血性脑病磁共振诊断与损伤类型的分类建议[J]. 中国当代儿科杂志, 2017, 19(12): 1225-1233. PMID: 29237520. PMCID: PMC7389802. DOI: 10.7499/j.issn.1008-8830.2017.12.001.
7 Wen YL, Hu J, Wang JQ, et al. Effect of glycolysis and heat shock proteins on hypoxia adaptation of Tibetan sheep at different altitude[J]. Gene, 2021, 803: 145893. PMID: 34384864. DOI: 10.1016/j.gene.2021.145893.
8 周茜茜, 胡长霞, 殷大欢, 等. 新生儿窒息程度与糖代谢紊乱的关系[J]. 中华围产医学杂志, 2016, 19(5): 336-339. DOI: 10.3760/cma.j.issn.1007-9408.2016.05.005.
9 Basu P, Som S, Choudhuri N, et al. Contribution of the blood glucose level in perinatal asphyxia[J]. Eur J Pediatr, 2009, 168(7): 833-838. PMID: 18843505. DOI: 10.1007/s00431-008-0844-5.
10 Basu SK, Kaiser JR, Guffey D, et al. Hypoglycaemia and hyperglycaemia are associated with unfavourable outcome in infants with hypoxic ischaemic encephalopathy: a post hoc analysis of the CoolCap Study[J]. Arch Dis Child Fetal Neonatal Ed, 2016, 101(2): F149-F155. PMID: 26283669. DOI: 10.1136/archdischild-2015-308733.
11 Nadeem M, Murray DM, Boylan GB, et al. Early blood glucose profile and neurodevelopmental outcome at two years in neonatal hypoxic-ischaemic encephalopathy[J]. BMC Pediatr, 2011, 11: 10. PMID: 21294901. PMCID: PMC3040139. DOI: 10.1186/1471-2431-11-10.
12 吴德, 崔珍珍, 朱静, 等. 目标-活动-运动环境疗法和神经发育学疗法对脑性瘫痪高风险儿早期干预效果的比较[J]. 中华实用儿科临床杂志, 2019, 34(11): 832-836. DOI: 10.3760/cma.j.issn.2095_428X.2019.11.008.
13 陈自励. 从循证角度审视新生儿窒息诊断和分度标准[J]. 中国当代儿科杂志, 2019, 21(1): 1-5. PMID: 30675855. PMCID: PMC7390175. DOI: 10.7499/j.issn.1008-8830.2019.01.001.
14 中华医学会围产医学分会新生儿复苏学组. 新生儿窒息诊断的专家共识[J]. 中华围产医学杂志, 2016, 19(1): 3-6. DOI: 10.3760/cma.j.issn.1007-9408.2016.01.002.
15 邵肖梅, 叶鸿瑁, 丘小汕. 实用新生儿学[M]. 4版. 北京: 人民卫生出版社, 2011.
16 Zhang S, Li BB, Zhang XL, et al. Birth asphyxia is associated with increased risk of cerebral palsy: a meta-analysis[J]. Front Neurol, 2020, 11: 704. PMID: 32765409. PMCID: PMC7381116. DOI: 10.3389/fneur.2020.00704.
17 Kamino D, Almazrooei A, Pang EW, et al. Abnormalities in evoked potentials associated with abnormal glycemia and brain injury in neonatal hypoxic-ischemic encephalopathy[J]. Clin Neurophysiol, 2021, 132(1): 307-313. PMID: 33158762. PMCID: PMC7855101. DOI: 10.1016/j.clinph.2020.09.024.
18 Doandes FM, Manea AM, Lungu N, et al. Clinical, biological and electroencephalographic monitoring of newborns with neurological risk in the neonatal intensive care unit[J]. Exp Ther Med, 2021, 22(1): 760. PMID: 34035857. PMCID: PMC8135117. DOI: 10.3892/etm.2021.10192.
19 Mattersberger C, Schm?lzer GM, Urlesberger B, et al. Blood glucose and lactate levels and cerebral oxygenation in preterm and term neonates—a systematic qualitative review of the literature[J]. Front Pediatr, 2020, 8: 361. PMID: 32903733. PMCID: PMC7438789. DOI: 10.3389/fped.2020.00361.
20 Jensen EC, Bennet L, Hunter CJ, et al. Post-hypoxic hypoperfusion is associated with suppression of cerebral metabolism and increased tissue oxygenation in near-term fetal sheep[J]. J Physiol, 2006, 572(Pt 1): 131-139. PMID: 16484307. PMCID: PMC1779646. DOI: 10.1113/jphysiol.2005.100768.
21 Levmore-Tamir M, Weiser G, Berliner E, et al. Stress hyperglycemia in a pediatric emergency department setting and its relationship to the underlying disease and outcome[J]. Isr Med Assoc J, 2020, 22(7): 431-434. PMID: 33236568.
22 Pinchefsky EF, Hahn CD, Kamino D, et al. Hyperglycemia and glucose variability are associated with worse brain function and seizures in neonatal encephalopathy: a prospective cohort study[J]. J Pediatr, 2019, 209: 23-32. PMID: 30982528. DOI: 10.1016/j.jpeds.2019.02.027.
23 Lear CA, Davidson JO, Mackay GR, et al. Antenatal dexamethasone before asphyxia promotes cystic neural injury in preterm fetal sheep by inducing hyperglycemia[J]. J Cereb Blood Flow Metab, 2018, 38(4): 706-718. PMID: 28387144. PMCID: PMC5888852. DOI: 10.1177/0271678X17703124.
24 Deragon MA, McCaig WD, Patel PS, et al. Mitochondrial ROS prime the hyperglycemic shift from apoptosis to necroptosis[J]. Cell Death Discov, 2020, 6(1): 132. PMID: 33298902. PMCID: PMC7693268. DOI: 10.1038/s41420-020-00370-3.
25 Spies EE, Lababidi SL, McBride MC. Early hyperglycemia is associated with poor gross motor outcome in asphyxiated term newborns[J]. Pediatr Neurol, 2014, 50(6): 586-590. PMID: 24731484. DOI: 10.1016/j.pediatrneurol.2014.01.043.