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. 2021 Jun 4;13(6):1930.
doi: 10.3390/nu13061930.

Neonatal Hyperglycemia Related to Parenteral Nutrition Affects Long-Term Neurodevelopment in Preterm Newborn: A Prospective Cohort Study

Giovanni Boscarino  1 , Maria Giulia Conti  1   2 , Corinna Gasparini  1 , Elisa Onestà  1 , Francesca Faccioli  1 , Lucia Dito  1 , Daniela Regoli  1 , Alberto Spalice  1 , Pasquale Parisi  3 , Gianluca Terrin  1
Affiliations

Neonatal Hyperglycemia Related to Parenteral Nutrition Affects Long-Term Neurodevelopment in Preterm Newborn: A Prospective Cohort Study

Giovanni Boscarino et al. Nutrients. .

Abstract

(1) Background: Recent evidence reported a reduced tolerance of macronutrient parenteral intakes in subjects in critically ill conditions. We designed a prospective cohort study to evaluate the effects of hyperglycemia (HG) related to parenteral nutrition (PN) on neurodevelopment (NDV) in survived preterm newborns. (2) Methods: Enrolled newborns with gestational age < 32 weeks or birth weight < 1500 g, were divided in two cohorts: (A) exposed to moderate or severe HG (glucose blood level > 180 mg/dL) in the first week of life; (B) not exposed to HG. We considered as the primary outcome the rate of preterm newborns survived without NDV delay at 24 months of life, evaluated with Bayley Scales of Infants Development III edition. (3) Results: We analyzed 108 (A 32 vs. B 76) at 24 months of life. Newborns in cohort A showed a higher rate of cognitive and motor delay (A 44% vs. B 22 %, p = 0.024; A 38% vs. B 8%, p < 0.001). When adjusting for background characteristics, HG remained a risk factor for motor delay. (4) Conclusions: High nutritional intakes through PN soon after birth increase the risk of HG. The consequences of this severe metabolic complication affect long-term NDV and survival in preterm newborns.

Keywords: Bayley Scales of Infants Development; VLBW; maternal age; metabolic complication; mortality; neurodevelopment.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flow chart. Figure legend: HG (hyperglycemia).
Figure 2
Figure 2
Logistic regression analysis to evaluate the influence of covariates on mortality rate. Figure legend: CRIB (clinical risk index for babies).
Figure 3
Figure 3
Daily energy intake of the first two weeks of life of the two study cohorts in total parenteral nutrition. Figure legend: HG (Hyperglycemia); * p-value < 0.05.
Figure 4
Figure 4
Multivariate analysis to evaluate the influence of covariates on the occurrence of hyperglycemia. Figure legend: CRIB (clinical risk index for babies); EN (enteral nutrition); PN (parenteral nutrition); TPN (total parenteral nutrition).
Figure 5
Figure 5
Percentage of children with neurodevelopment delay in each domain of Bayley Scale of Infant Development at 24 months of life of the two study cohorts. Figure legend: HG (hyperglycemia); * p-value < 0.05; ** p-value < 0.01; *** p-value < 0.001.
Figure 6
Figure 6
Multivariate analysis to evaluate the influence of covariates on the occurrence of neurodevelopment delay in each domain of Bayley Scales of Infants Development at 24 months of life. (A) All enrolled newborns; (B) Newborns receiving total parenteral nutrition in the first week of life. Figure legend: EUGR (extrauterine growth retardation); ELBW (extremely low birth weight infants).
See this image and copyright information in PMC

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