ESPE Abstracts (2018) 89 P-P2-189

Neonatal Hypoglycaemia: Unchanged Risk of Neurodevelopmental Impairment, But Sex-Specific Decreased Fine Motor Function and Increased Internalizing Behaviour at School Age

Annett Helleskova, Sonja Wehbergb, Fani Juel Pørtnera, Anna-Marie Larsenc, Karen Filipsenc & Henrik Thybo Christesena,d

aHans Christian Andersen Children’s Hospital, Odense University Hospital, Odense, Denmark; bDepartment of Epidemiology, Odense University Hospital, Odense, Denmark; cDepartment of Rehabilitation, Odense University Hospital, Odense, Denmark; dInstitute of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark

The neurodevelopmental consequences of neonatal hypoglycaemia are sparsely studied. We included neonates with blood glucose <1.7 mmol/L, but no severe perinatal risk factors, in a follow-up with blinded Wechsler’s Intelligence Scale for Children-IV (WISC-IV), Movement ABC-2 tests and child behaviour checklist (CBCL). Neurodevelopmental impairment was defined as psychomotor retardation, blindness, epilepsy, cerebral palsy, WISC-IV score <70, or Movement ABC-2 <15th percentile. Seventy-one children with neonatal hypoglycaemia aged median (range) 7.75 (6.0-8.45) years were compared with 32 control siblings aged 9.17(3.75-16.0) years. Neurodevelopmental impairment was observed in 15% vs. 8.7% (P=0.25). In univariate analysis, the hypoglycaemia group had lower total motor and fine motor scores compared to controls, 48(40.5-72.4) vs. 61(49.1-72.4) percentile (trend P=0.07), and 43(34.8-50.3) vs. 57(45.6-68.7) percentile (P=0.03), respectively. Multivariable regression analysis showed a trend towards lower fine motor score after hypoglycaemia, β -11.3, P=0.10, driven by boys within the hypoglycaemia group, β -16.4, P=0.048, Furthermore, girls had a higher internalizing CBCL score in the hypoglycaemia group, P=0.02.

Conclusion: Neonatal hypoglycaemia was not associated with neurodevelopmental impairment at 7.75 years. However, boys had lower fine motor score and girls had higher internalizing score after hypoglycaemia, suggesting a novel identified, sex-specific, differential vulnerability in neonates with hypoglycaemia.

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