Short and long term outcome of neonatal hyperglycemia in very preterm infants a retrospective follow-up study 英文参考文献.docVIP

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Short and long term outcome of neonatal hyperglycemia in very preterm infants a retrospective follow-up study 英文参考文献.doc

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Short and long term outcome of neonatal hyperglycemia in very preterm infants a retrospective follow-up study 英文参考文献

vanderLugtetal.BMCPediatrics2010,10:52 /1471-2431/10/52 RESEARCH ARTICLE OpenAccess Shortandlongtermoutcomeofneonatal hyperglycemiainverypreterminfants:a retrospectivefollow-upstudy NMargrethvanderLugt1,VivianneEHJSmits-Wintjens1,PaulHTvanZwieten2,FransJWalther1* Abstract Background:Hyperglycemiainprematureinfantsisassociatedwithincreasedmorbidityandmortality,butdataon long-termoutcomearelimited.Weinvestigatedtheeffectsofneonatalhyperglycemia(bloodglucose≥10mmol/l, treatedwithinsulinfor≥12hours)ongrowthandneurobehavioraloutcomeat2yearsofage. Methods:Retrospectivefollow-upstudyat2yearsofageamong859infants≤32weeksofgestationadmittedto atertiaryneonatalcenterbetweenJanuary2002andDecember2006.Thirty-threesurvivorstreatedwithinsulinfor hyperglycemiaand63matchedcontrolswithouthyperglycemiawereevaluatedatacorrectedageof2years. Outcomemeasuresconsistedofgrowth(weight,length,andheadcircumference)andneurologicaland behaviouraldevelopment. Results:66/859(8%)infants≤32weeksofgestationdevelopedhyperglycemia.Mortalityduringadmissionwas 27/66(41%)inthehyperglycemiagroupversus62/793(8%)inthosewithouthyperglycemia(p0.001).Mortality washigherininfantswithhyperglycemiawithabirthweight≤1,000gram(p=0.005)and/orgestationalageof 24-28weeks(p=0.009)thanincontrolinfantswithouthyperglycemia.Sepsiswasmoreprominentininfantswith hyperglycemiaandabirthweightof1,000gram(p=0.002)and/orgestationalageof29-32weeks(p=0.009) thanincontrolinfantswithouthyperglycemia.Growthat2yearsofagewassimilar,butneurologicaland behaviouraldevelopmentwasmorefrequentlyabnormalamongthosewithneonatalhyperglycemia(p=0.036 and0.021respectively). Conclusions:Mortalitywashigherinverypreterminfantswithhyperglycemiatreatedwithinsulinduringthe neonatalperiod.At2yearsofagesurvivorsshowednormalgrowth,butahigherincidenceofneurologicaland behaviouralproblems.Betterstrategiestomanagehyperglycemiamayimproveoutcomeofverypreterminfants. Background consequences. Hyperglycemia is associated with Hyperglycemia is a common problem in