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European Journal of Pediatrics
Erschienen in: European Journal of Pediatrics 3/2024

05.01.2024 | REVIEW

Neonatal hypoglycemia and neurodevelopmental outcomes: Yesterday, today, tomorrow

verfasst von: Domenico Umberto De Rose, Alessandro Perri, Luca Maggio, Guglielmo Salvatori, Andrea Dotta, Giovanni Vento, Francesca Gallini

Erschienen in: European Journal of Pediatrics | Ausgabe 3/2024

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Abstract

Neonatal hypoglycemia is a major source of concern for pediatricians since it has commonly been related to poor neurodevelopmental outcomes. Diagnosis is challenging, considering the different operational thresholds provided by each guideline. Screening of infants at risk plays a crucial role, considering that most hypoglycemic infants show no clinical signs. New opportunities for prevention and treatment are provided by the use of oral dextrose gel. Continuous glucose monitoring systems could be a feasible tool in the next future. Furthermore, there is still limited evidence to underpin the current clinical practice of administering, in case of hypoglycemia, an intravenous “mini-bolus” of 10% dextrose before starting a continuous dextrose infusion. This brief review provides an overview of the latest advances in this field and neurodevelopmental outcomes according to different approaches.
   Conclusion: To adequately define if a more permissive approach is risk-free for neurodevelopmental outcomes, more research on continuous glucose monitoring and long-term follow-up is still needed.
What is Known:
• Neonatal hypoglycemia (NH) is a well-known cause of brain injury that could be prevented to avoid neurodevelopmental impairment.
• Diagnosis is challenging, considering the different suggested operational thresholds for NH (<36, <40, <45, <47 or <50 mg/dl).
What is New:
• A 36 mg/dl threshold seems to be not associated with a worse psychomotor development at 18 months of life when compared to the “traditional” threshold (47 mg/dl).
• Further studies on long-term neurodevelopmental outcomes are required before suggesting a more permissive management of NH.
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Metadaten
Titel
Neonatal hypoglycemia and neurodevelopmental outcomes: Yesterday, today, tomorrow
verfasst von
Domenico Umberto De Rose
Alessandro Perri
Luca Maggio
Guglielmo Salvatori
Andrea Dotta
Giovanni Vento
Francesca Gallini
Publikationsdatum
05.01.2024
Verlag
Springer Berlin Heidelberg
Erschienen in
European Journal of Pediatrics / Ausgabe 3/2024
Print ISSN: 0340-6199
Elektronische ISSN: 1432-1076
DOI
https://doi.org/10.1007/s00431-023-05405-2

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