Association Between Transient Newborn Hypoglycemia and Fourth-Grade Achievement Test Proficiency A Population-Based Study
Association Between Transient Newborn Hypoglycemia and Fourth-Grade Achievement Test Proficiency A Population-Based Study
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DOI：
10.1001/jamapediatrics.2015.1631
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发表时间：
2015-10-01
期刊：
影响因子：
26.1
通讯作者：
ElHassan, Nahed O.
中科院分区：
文献类型：
--
作者：
Kaiser, Jeffrey R.;Bai, Shasha;ElHassan, Nahed O.
新生儿长期低血糖与长期神经认知功能不良有关。然而，关于新生儿早期短暂性低血糖与学业成绩之间的关系，我们所知甚少。目的：确定早期（出生后3小时内）短暂性低血糖（单次初始低血糖浓度，随后第二次高于临界值）是否与随后较差的学习成绩有关。设计、环境和参与者对1998年1月1日至1998年12月31日在阿肯色大学医学科学学院出生的所有至少有1次葡萄糖浓度记录的婴儿进行了一项基于人群的回顾性队列研究（一项有效的新生儿葡萄糖筛查政策）。患有正常血糖或短暂性低血糖的新生儿的医疗记录数据与他们2008年阿肯色州教育部的学生成绩测试成绩相匹配，并进行了匿名化。基于围生期因素，建立Logistic回归模型评估短暂性低血糖与学龄学业成就测试能力的关系。研究了葡萄糖水平低于35mg /dL（原发性）和低于40mg /dL和45mg /dL（继发性）的常见低血糖临界值。所有1943例血糖正常和短暂性低血糖婴儿（妊娠23-42周）符合纳入研究的条件。长期低血糖、先天性异常或染色体异常的婴儿被排除在研究之外。新生儿低血糖症。主要结果和测量主要结果是10岁时四年级读写和数学成绩测试的熟练程度。我们先验地假设，与血糖正常的新生儿相比，早期一过性低血糖的新生儿在四年级成绩测试中的熟练程度较低。结果1395对新生儿（71.8%）围产期资料与四年级学业成就测验成绩相符。短暂性低血糖（血糖水平）
IMPORTANCE Prolonged neonatal hypoglycemia is associated with poor long-term neurocognitive function. However, little is known about an association between early transient newborn hypoglycemia and academic achievement.OBJECTIVE To determine if early (within the first 3 hours of life) transient hypoglycemia (a single initial low glucose concentration, followed by a second value above a cutoff) is associated with subsequent poor academic performance.DESIGN, SETTING, AND PARTICIPANTS A retrospective population-based cohort study of all infants born between January 1, 1998, and December 31, 1998, at the University of Arkansas for Medical Sciences who had at least 1 recorded glucose concentration (a universal newborn glucose screening policy was in effect) was conducted. Medical record data from newborns with normoglycemia or transient hypoglycemia were matched with their student achievement test scores in 2008 from the Arkansas Department of Education and anonymized. Logistic regression models were developed to evaluate the association between transient hypoglycemia and school-age achievement test proficiency based on perinatal factors. Common hypoglycemia cutoffs of a glucose level less than 35 mg/dL (primary) and less than 40 and 45 mg/dL (secondary) were investigated. All 1943 normoglycemic and transiently hypoglycemic infants (23-42 weeks' gestation) were eligible for inclusion in the study. Infants with prolonged hypoglycemia, congenital anomalies, or chromosomal abnormalities were excluded from the study.EXPOSURE Hypoglycemia as a newborn.MAIN OUTCOMES AND MEASURES The primary outcome was proficiency on fourth-grade literacy and mathematics achievement tests at age 10 years. We hypothesized a priori that newborns with early transient hypoglycemia would be less proficient on fourth-grade achievement tests compared with normoglycemic newborns.RESULTS Perinatal data were matched with fourth-grade achievement test scores in 1395 newborn-student pairs (71.8%). Transient hypoglycemia (glucose level