Glycemia and Neonatal Encephalopathy: Outcomes in the LyTONEPAL (Long-Term Outcome of Neonatal Hypoxic EncePhALopathy in the Era of Neuroprotective Treatment With Hypothermia) Cohort

Guellec, Isabelle; Ancel, Pierre–Yves; Beck, J.; Loron, Gauthier; Chevallier, Marie; Pierrat, Véronique; Kayem, Gilles; Vilotitch, Antoine; Baud., Olivier; Ego, Anne; Debillon, Thierry

doi:10.1016/j.jpeds.2023.02.003

Cited by 11 publications

(15 citation statements)

References 40 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Twelve studies were selected for inclusion (table 1, online supplemental eTable 2). 7–11 18–24 As far as hypoglycaemia is concerned, data were extracted for a total of 685 neonates with NE for the primary outcome (six studies), a total of 634 for the secondary outcome of brain injury on conventional MRI (four studies) and a total of 329 for cerebral palsy (three studies). Seven of the studies included (807 infants) reported data on the association between hyperglycaemia and primary outcome 9–11 20–22…”

Section: Resultsmentioning

confidence: 99%

“…The studies were all conducted in developed countries. Overall, 10 out of 12 studies reported the primary outcome,8–11 19–24 4 of which also showed the secondary outcome defined as the presence of brain injury on conventional MRI,23 cerebral palsy9 19 or both 8. Two studies reported only secondary outcome 7 18.…”

Section: Resultsmentioning

confidence: 99%

“…Two studies reported only secondary outcome 7 18. Nine studies adjusted results for potential confounding variables 7–10 18–20 23 24…”

Section: Resultsmentioning

confidence: 99%

“…The finding that hyperglycaemia is associated with a higher risk of brain injury and adverse outcome in NE is more recent. In three prospective cohort studies, which included neonates undergoing TH, hyperglycaemia was associated with increased odds of predominant basal ganglia or global injury 7 23 31. In another cohort of infants with NE who underwent TH, higher maximal glucose on the first day of age was associated with microstructural changes on brain imaging 32…”

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Hypoglycaemia and hyperglycaemia in neonatal encephalopathy: a systematic review and meta-analysis

Puzone

Diplomatico

Caredda

et al. 2023

Arch Dis Child Fetal Neonatal Ed

View full text Add to dashboard Cite

ImportanceAlthough hypoglycaemia and hyperglycaemia represent the most common metabolic problem in neonates, there is still uncertainty regarding the effects of glucose homoeostasis on the neurological outcomes of infants with neonatal encephalopathy (NE).ObjectiveTo systematically investigate the association between neonatal hypoglycaemia and hyperglycaemia with adverse outcome in children who suffered from NE.Study selectionWe searched Pubmed, Embase and Web of Science databases to identify studies which reported prespecified outcomes and compared infants with NE who had been exposed to neonatal hypoglycaemia or hyperglycaemia with infants not exposed.Data analysisWe assessed the risk of bias (ROBINS-I), quality of evidence (Grading of Recommendations, Assessment, Development and Evaluation (GRADE)) for each of the studies. RevMan was used for meta-analysis (inverse variance, fixed effects).Main outcomeDeath or neurodevelopmental outcomes at 18 months of age or later.Results82 studies were screened, 28 reviewed in full and 12 included. Children who were exposed to neonatal hypoglycaemia had higher odds of neurodevelopmental impairment or death (6 studies, 685 infants; 40.6% vs 25.4%; OR=2.17, 95% CI 1.46 to 3.25; p=0.0001). Neonatal exposure to hyperglycaemia was associated with death or neurodisability at 18 months or later (7 studies, 807 infants; 46.1% vs 28.0%; OR=3.07, 95% CI 2.17 to 4.35; p<0.00001). These findings were confirmed in the subgroup analysis, which included only the infants who underwent therapeutic hypothermia.ConclusionsThese data suggest that neonatal hypoglycaemia and hyperglycaemia may be associated with the neurodevelopmental outcome later on in infants with NE. Further studies with long-term follow-up are needed to optimise the metabolic management of these high-risk infants.PROSPERO registration numberCRD42022368870.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

“…Two studies reported only secondary outcome 7 18. Nine studies adjusted results for potential confounding variables 7–10 18–20 23 24…”

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Hypoglycaemia and hyperglycaemia in neonatal encephalopathy: a systematic review and meta-analysis

Puzone

Diplomatico

Caredda

et al. 2023

Arch Dis Child Fetal Neonatal Ed

View full text Add to dashboard Cite

show abstract

“…Hyperglycemia may also occur and reflects reduced tissue uptake and utilization. 58 Prompt treatment is considered critical, because both hypoglycemia and hyperglycemia have been associated with an increased risk of neurodevelopmental disability. [58][59][60] Finally, neonates with HIE are at increased risk of neurodevelopmental problems in childhood.…”

Section: Metabolicmentioning

confidence: 99%

Neonatal Hypoxic-Ischemic Encephalopathy and Hypothermia Treatment

Arnautovic,

Sinha,

Laptook

2023

Obstetrics &Amp; Gynecology

View full text Add to dashboard Cite

Neonatal hypoxic-ischemic encephalopathy (HIE) is an important clinical entity because it is associated with death and long-term disability, including cognitive impairment, cerebral palsy, seizures, and neurosensory deficits. Over the past 40 years, there has been an intensive search to identify therapies to improve the prognosis of neonates with HIE. Hypothermia treatment represents the culmination of laboratory investigations including small and large animal studies, followed by pilot human studies, and, finally, randomized controlled trials to establish efficacy and safety. Clinical trials have demonstrated that hypothermia treatment reduces mortality and improves early childhood outcome among survivors. Hypoxic-ischemic encephalopathy is a multi-system disease process that requires intensive medical support for brain monitoring and monitoring of non–central nervous system organ dysfunction. Treatment must be conducted in a level III or IV neonatal intensive care unit with infrastructure for an integrated approach to care for critically ill neonates. Hypothermia treatment is the first and currently the only therapy to improve outcomes for neonates with HIE and indicates that HIE is modifiable. However, outcomes likely can be improved further. Hypothermia treatment has accelerated investigation of other therapies to combine with hypothermia. It has also stimulated a more intensive approach to brain monitoring, which allows earlier intervention for complications. Finally, HIE and hypothermia treatment negatively influences the psychological state of affected families, and there is growing recognition of the importance of trauma-informed principles to guide medical professionals.

show abstract

Relationship between EEG spectral power and dysglycemia with neurodevelopmental outcomes after neonatal encephalopathy

Damien,

Vannasing,

Tremblay

et al. 2024

Clinical Neurophysiology

View full text Add to dashboard Cite

Glycemia and Neonatal Encephalopathy: Outcomes in the LyTONEPAL (Long-Term Outcome of Neonatal Hypoxic EncePhALopathy in the Era of Neuroprotective Treatment With Hypothermia) Cohort

Cited by 11 publications

References 40 publications

Hypoglycaemia and hyperglycaemia in neonatal encephalopathy: a systematic review and meta-analysis

Hypoglycaemia and hyperglycaemia in neonatal encephalopathy: a systematic review and meta-analysis

Neonatal Hypoxic-Ischemic Encephalopathy and Hypothermia Treatment

Relationship between EEG spectral power and dysglycemia with neurodevelopmental outcomes after neonatal encephalopathy

Contact Info

Product

Resources

About