Incidence and Risk Factors for Glucose Disturbances in Premature Infants
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Group
- -
- Normoglycemic (a single blood glucose level of 2.1–2.5 mmol/L (38–45 mg/dL) or a single blood glucose level of 8.6–10.0 mmol/L (155–180 mg/dL), with all other measurements 2.6–8.5 mmol/L (47–153 mg/dL));
- -
- Hypoglycemic (blood glucose level of ≤2.5 mmol/L (45 mg/dL) on ≥2 measurements >1 h apart, or any blood glucose level ≤ 2.0 mmol/L (36 mg/dL));
- -
- Hyperglycemic (blood glucose level ≥ 8.6 mmol/L (155 mg/dL) on ≥2 measurements >1 h apart, or any blood glucose level ≥ 10.1 mmol/L (182 mg/dL));
- -
- Unstable (≥1 blood glucose level ≤ 2.5 mmol/L (45 mg/dL) and ≥1 blood glucose level ≥ 8.6 mmol/L (155 mg/dL)) [4].
2.2. Methods
2.3. Ethical Statement
2.4. Statistical Analyses
3. Results
3.1. Characteristics of the Studied Group
3.2. Risk Factors for the Development of Hypoglycemia
3.3. Risk Factors for the Development of Hyperglycemia
3.4. Risk Factors for the Development of Unstable Glycemia
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Glycemic Category, n (%) | |||||
---|---|---|---|---|---|
Normoglycemic 296 (66.5%) | Hypoglycemic 92 (20.7%) | Hyperglycemic 44 (9.9%) | Unstable 13 (2.9%) | Total 445 | |
Infant data | |||||
Female, n (%) | 134 (45.3%) | 49 (53.3%) | 22 (50.0%) | 4 (30.8%) | 209 (46.9%) |
Gestational age (weeks) ** | 33 ± 3 | 33 ± 2 | 28 ± 2 | 28 ± 3 | 32 ± 3 |
<28 weeks GA, n (%) | 14 (4.7%) | 1 (1.1%) | 23 (52.3%) | 8 (61.5%) | 46 (10.3%) |
28 to ≤31 weeks GA, n (%) | 85 (28.7%) | 19 (20.7%) | 17 (38.6%) | 2 (15.4%) | 123 (27.6%) |
32 to ≤33 GA weeks, n (%) | 66 (22.3%) | 21 (22.8%) | 4 (9.1%) | 2 (15.4%) | 93 (20.9%) |
≥34 GA weeks, n (%) | 131 (44.3%) | 51 (55.4%) | 0 (0.0%) | 1 (7.7%) | 183 (41.1%) |
Birth weight (g) ** | 1975 ± 598 | 1952 ± 572 | 1106 ± 445 | 1001 ± 419 | 1856 ± 646 |
SGA, n (%) LGA, n (%) | 166 (56.1%) | 61 (66.3%) | 30 (68.2%) | 11 (84.6%) | 268 (60.2%) |
5 (1.7%) | 1 (1.1%) | 0 | 0 | 6 (1.3%) | |
Apgar score at 1 min ** | 8 ± 2 | 8 ± 2 | 5 ± 2 | 5 ± 2 | 8 ± 2 |
Apgar score at 5 min ** | 9 ± 1 | 9 ± 1 | 7 ± 2 | 6 ± 2 | 8 ± 2 |
CRIB II score ** | 4 ± 3 | 4 ± 3 | 8 ± 3 | 10 ± 3 | 5 ± 4 |
Length of hospital stay (days) ** | 20 ± 18 | 18 ± 15 | 73 ± 54 | 64 ± 44 | 26 ± 30 |
Blood gas at birth | |||||
pH * | 7.33 ± 0.07 | 7.32 ± 0.09 | 7.30 ± 0.08 | 7.28 ± 0.08 | 7.32 ± 0.08 |
pCCO2 | 5.8 ± 1.9 | 6.0 ± 1.6 | 6.3 ± 1.6 | 5.7 ± 1.3 | 5.9 ± 1.8 |
Base excess * | −3.1 ± 4.0 | −3.7 ± 3.1 | −3.3 ± 2.9 | −6.2 ± 4.0 | −3.3 ± 4.0 |
Maternal data | |||||
Cesarean section, ** n (%) | 167 (56.4%) | 56 (60.9%) | 34 (77.3%) | 9 (69.2%) | 266 (59.8%) |
Maternal gestational or pre-existing diabetes mellitus, n (%) | 48 (16.2%) | 15 (16.3%) | 5 (11.4%) | 2 (15.4%) | 70 (15.7%) |
Pregnancy-induced hypertension, n (%) | 38 (12.8%) | 12 (13.0%) | 11 (25.0%) | 0 | 61 (13.7%) |
Antenatal glucocorticoids, ** n (%) (administered to infants <34 GA) | 160 (54.1%) | 42 (45.7%) | 43 (97.7%) | 12 (92.3%) | 257 (57.8%) |
Postnatal complications | |||||
Necrotizing enterocolitis, ** n (%) | 10 (2.2%) | 4 (1.35%) | 2 (2.2%) | 3 (6.82%) | 1 (7.7%) |
Sepsis ** n (%) | 13 (4.4%) | 2 (2.2%) | 12 (27.3%) | 3 (23.1%) | 30 (6.7%) |
Mechanical ventilation, **n (%) | 83 (28.0%) | 14 (15.2%) | 33 (75.0%) | 9 (69.2%) | 139 (31.2%) |
RDS ** n (%) | 66 (14.8%) | 35 (11.2%) | 6 (6.52%) | 21 (47.7%) | 4 (3.8%) |
Variable | Univariate Analysis | Multivariate Analysis | ||||||||
---|---|---|---|---|---|---|---|---|---|---|
Beta | p | OR | 95% CI | P | Beta | p | OR | 95% CI | p | |
Sex (female) | 1.239 | 0.032 | 3.45 | 1.11–10.7 | 0.038 | 1.136 | 0.030 | 3.12 | 1.11–3.72 | 0.031 |
GA (weeks) | 0.262 | 0.347 | 1.30 | 0.75–0.25 | 0.561 | 0.408 | 0.078 | 1.50 | 0.95–2.36 | 0.061 |
SGA | 0.098 | 0.869 | 1.10 | 0.34–3.56 | 0.871 | Eliminated | ||||
LGA | −19.22 | 0.999 | 0.00 | Eliminaated | ||||||
Vaginal delivery | 0.121 | 0.830 | 1.13 | 0.37–3.39 | 0.852 | Eliminated | ||||
Apgar score at 1 min | −0.439 | 0.193 | 0.64 | 0.33–1.25 | 0.458 | Eliminated | ||||
Apgar score at 5 min | 0.677 | 0.130 | 1.97 | 0.82–4.72 | 0.568 | Eliminated | ||||
CRIB II | 0.223 | 0.193 | 1.25 | 0.89–1.75 | 0.462 | 0.227 | 0.096 | 1.25 | 0.96–1.64 | 0.062 |
pH | −4.126 | 0.283 | 0.02 | 0.00–29.9 | 0.856 | Eliminated | ||||
BE | 0.027 | 0.606 | 1.03 | 0.93–1.14 | 0.269 | Eliminated | ||||
pCO2 | −0.086 | 0.492 | 0.92 | 0.72–1.17 | 0.412 | Eliminated | ||||
Antenatal glucocorticoids | 20.346 | 0.999 | 0.00 | Eliminated | ||||||
Pregnancy-induced hypertension | −0.285 | 0.685 | 0.75 | 0.19–2.98 | 0.563 | Eliminated | ||||
Maternal diabetes | −0.635 | 0.462 | 0.53 | 0.09–2.88 | 0.696 | Eliminated | ||||
Sepsis | −0.729 | 0.523 | 0.48 | 0.05–4.53 | 0.795 | Eliminated | ||||
NEC | 0.253 | 0.849 | 1.29 | 0.09–17.4 | 0.981 | Eliminated | ||||
RDS | −1.203 | 0.130 | 0.30 | 0.06–1.42 | 0.691 | Eliminated |
Variable | Univariate Analysis | Multivariate Analysis | |||||||||
---|---|---|---|---|---|---|---|---|---|---|---|
Beta | p-Value | OR | 95% CI | p-Value | Beta | p-Value | OR | 95% CI | p-Value | ||
Sex (female) | −0.083 | 0.877 | 0.92 | 0.32–2.64 | 0.654 | Excluded | |||||
GA (weeks) | −0.639 | 0.032 | 0.53 | 0.29–0.94 | 0.042 | −0.059 | <0.001 | 0.55 | 0.44–0.69 | 0.002 | |
BW < 1000 g | −0.247 | 0.765 | 0.78 | 0.15–3.94 | 0.698 | Eliminated | |||||
Vaginal delivery | −0.468 | 0.457 | 0.63 | 0.18–2.15 | 0.598 | Eliminated | |||||
Apgar score at 1 min | 0.079 | 0.776 | 1.08 | 0.63–1.87 | 0.453 | Eliminated | |||||
Apgar score at 5 min | −0.194 | 0.592 | 0.82 | 0.40–1.68 | 0.651 | Eliminated | |||||
CRIB II | 0.122 | 0.506 | 1.13 | 0.79–1.62 | 0.462 | Eliminated | |||||
pH | −13.14 | 0.047 | 0.00 | 0.00–0.87 | 0.045 | Eliminated | |||||
BE | 0.123 | 0.087 | 1.13 | 0.98–1.30 | 0.212 | Eliminated | |||||
pCO2 | −0.480 | 0.153 | 0.62 | 0.32–1.19 | 0.421 | Eliminated | |||||
Antenatal glucocorticoids | 3.027 | 0.078 | 20.63 | 0.71–596 | 0.892 | Eliminated | |||||
Pregnancy-induced hypertension | 0.364 | 0.604 | 1.44 | 0.36–5.69 | 0.653 | Eliminated | |||||
Maternal diabetes | −1.118 | 0.197 | 0.33 | 0.06–1.78 | 0.798 | Eliminated | |||||
Sepsis | 1.713 | 0.017 | 5.55 | 1.35–22.8 | 0.001 | 1.962 | 0.001 | 7.08 | 2.2–22.9 | 0.001 | |
NEC | −1.200 | 0.270 | 0.30 | 0.04–2.54 | 0.614 | Eliminated | |||||
RDS | 1.918 | <0.001 | 6.81 | 3.42–13.6 | <0.001 | 1.565 | <0.001 | 4.78 | 1.89–2.1 | <0.001 | |
Mechanical ventilation | 1.157 | 0.050 | 3.18 | 1.01–10.37 | 0.048 | 1.080 | 0.042 | 2.95 | 1.03–8.4 | 0.032 |
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Butorac Ahel, I.; Lah Tomulić, K.; Vlašić Cicvarić, I.; Žuvić, M.; Baraba Dekanić, K.; Šegulja, S.; Bilić Čače, I. Incidence and Risk Factors for Glucose Disturbances in Premature Infants. Medicina 2022, 58, 1295. https://doi.org/10.3390/medicina58091295
Butorac Ahel I, Lah Tomulić K, Vlašić Cicvarić I, Žuvić M, Baraba Dekanić K, Šegulja S, Bilić Čače I. Incidence and Risk Factors for Glucose Disturbances in Premature Infants. Medicina. 2022; 58(9):1295. https://doi.org/10.3390/medicina58091295
Chicago/Turabian StyleButorac Ahel, Ivona, Kristina Lah Tomulić, Inge Vlašić Cicvarić, Marta Žuvić, Kristina Baraba Dekanić, Silvije Šegulja, and Iva Bilić Čače. 2022. "Incidence and Risk Factors for Glucose Disturbances in Premature Infants" Medicina 58, no. 9: 1295. https://doi.org/10.3390/medicina58091295