Early hyperglycemia linked to increased risk of severe retinopathy of prematurity in preterm infants

Preterm infants have a higher rate of hyperglycemia and hypoglycemia, both of which have been tied to increased neonatal morbidities. Jihan Esmail, The University of Tennessee Health Science Center College of Medicine Memphis, Memphis, United States, and colleagues aimed to evaluate the incidence of abnormal glucose homeostasis during the first 72 hours of life and they studied its association with major morbidities in infants admitted to the NICU (neonatal intensive care unit).

For this purpose, they designed a retrospective single-centre study. They extracted maternal, demographic, and patient information and blood glucose levels for the first 82 hours of life for all infants with birthweight ≤1000g admitted to the NICU from 2017 to 2019. Continuous data were presented as mean ± SD or as median with interquartile range. Categorical data were presented as percentages and frequency.

Mann-Whitney U test and Student's t-tests were used to analyze continuous data and Fisher's exact test or chi-squared test were used to analyze categorical data. The relation between hyperglycemia and various morbidities was studied after controlling for gestational age (GA) through logistic regression analysis.

The study revealed the following findings:

• Of the 235 infants included in the study, 49% were hypoglycemic at admission to the NICU.
• Infants that were small for GA and those with a history of maternal β-blocker use had a higher incidence of hypoglycemia.
• Hypoglycemia at admission was not associated with increased mortality or any major morbidities.
• Seventy-three per cent of infants who were hypoglycemic or euglycemic at birth developed iatrogenic hyperglycemia during the first 72 hours of life.
• The incidence of ROP and severe ROP was higher in infants with hyperglycemia on univariate analysis.
• On multivariate analysis, after adjusting for GA, no difference was noted in the incidence of ROP between the two groups.
• Multivariate analysis could not be performed for severe ROP due to inadequate sample size.

"The findings revealed that early hyperglycemia is associated with increased incidence of severe retinopathy of prematurity in extremely low birth weight infants," the researchers concluded.

Reference:

Esmail, Jihan, et al. "Early Hyperglycemia Is Associated With Increased Incidence of Severe Retinopathy of Prematurity in Extremely Low Birth Weight Infants." American Journal of Perinatology, 2023.