Two-year outcomes after dextrose gel prophylaxis for neonatal hypoglycaemia. Issue 3 (4th November 2020)

• Record Type: Journal Article
• Authors: Griffith, Rebecca; Hegarty, Joanne Elizabeth; Alsweiler, Jane M; Gamble, Greg D; May, Robyn; McKinlay, Christopher Joel Dorman; Thompson, Benjamin; Wouldes, Trecia Ann; Harding, Jane E
• Is Part Of: Archives of disease in childhood. Volume 106:Issue 3(2021)
• Page Start: 278
• Page End: 285
• Publication Date: 2020-11-04
• Subjects: neonatology -- neurology; Infants -- Diseases -- Periodicals; Newborn infants -- Diseases -- Periodicals; Fetus -- Diseases -- Periodicals; 618.920105
• DOI: 10.1136/archdischild-2020-320305
• Languages: English
• ISSNs: 1359-2998

Abstract

Abstract : Objective: To determine the effect of prophylactic dextrose gel for prevention of neonatal hypoglycaemia on neurodevelopment and executive function at 2 years' corrected age. Design: Prospective follow-up of a randomised trial. Setting: New Zealand. Patients: Participants from the pre-hypoglycaemia Prevention with Oral Dextrose (pre-hPOD) trial randomised to one of four dose regimes of buccal 40% dextrose gel or equivolume placebo. Main outcome measures: Coprimary outcomes were neurosensory impairment and executive function. Secondary outcomes were components of the primary outcomes, neurology, anthropometry and health measures. Results: We assessed 360 of 401 eligible children (90%) at 2 years' corrected age. There were no differences between dextrose gel dose groups, single or multiple dose groups, or any dextrose and any placebo groups in the risk of neurosensory impairment or low executive function (any dextrose vs any placebo neurosensory impairment: relative risk (RR) 0.77, 95% CI 0.50 to 1.19, p=0.23; low executive function: RR 0.50, 95% CI 0.24 to 1.06, p=0.07). There were also no differences between groups in any secondary outcomes. There was no difference between children who did or did not develop neonatal hypoglycaemia in the risk of neurosensory impairment (RR 1.05, 95% CI 0.68 to 1.64, p=0.81) or low executive function (RR 0.73, 95% CI 0.34 to 1.59, p=0.43). Conclusion: Prophylactic dextrose gel did not alter neurodevelopment or executive function and had no adverse effects to 2 years' corrected age, but this study was underpowered to detect potentially clinically important effects on neurosensory outcomes.