Outcomes of very preterm infants with neonatal hyperglycaemia: a systematic review and meta-analysis.
Arch Dis Child Fetal Neonatal Ed
; 107(3): 269-280, 2022 May.
Article
en En
| MEDLINE
| ID: mdl-34330757
ABSTRACT
OBJECTIVE:
To explore the association between hyperglycaemia and adverse outcomes in very preterm infants.DESIGN:
Systematic review and meta-analysis. Data were pooled separately for adjusted and unadjusted odds ratios (ORs) using random-effects model. Subgroup analysis was conducted based on study design (cohort and case control). MAIN OUTCOMEMEASURES:
Association between hyperglycaemia in preterm neonates (<32 weeks or <1500 g) and mortality and morbidities.FINDINGS:
Forty-six studies (30 cohort and 16 case control) with data from 34 527 infants were included. Meta-analysis of unadjusted ORs from cohort studies found hyperglycaemia to be significantly associated with mortality, any-grade intraventricular haemorrhage (IVH), severe IVH, any-stage retinopathy of prematurity (ROP), severe ROP, sepsis, chronic lung disease and disability. However, pooling of adjusted ORs found significant associations only for mortality (adjusted OR (CI) 2.37 (1.40 to 4.01); I2 36%; 6 studies), 'Any grade IVH' (adjusted OR (CI) 2.60 (1.09 to 6.20); I2 0%; 2 studies) and 'Any stage ROP' (adjusted OR (CI) 3.70 (1.55 to 8.84); I2 0%; 2 studies). Meta-regression analysis found glucose levels >10 mmol/L to be associated with increased odds of mortality compared with <10 mmol/L. Pooled analysis from case-control studies were similar to cohort studies for most outcomes but limited by small sample size. Longer duration of hyperglycaemia was associated with adverse outcomes. GRADE of evidence was 'Low' or 'Very low'.CONCLUSION:
Hyperglycaemia in very preterm infants is associated with higher odds of mortality, any-grade IVH and any-stage ROP. A limitation was lack of availability of adjusted ORs from many of the included studies. PROSPERO REGISTRATION NUMBER CRD42020193016.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Contexto en salud:
2_ODS3
/
6_ODS3_enfermedades_notrasmisibles
/
7_ODS3_muertes_prevenibles_nacidos_ninos
Problema de salud:
2_muertes_prevenibles
/
6_endocrine_disorders
/
7_neonatal_care_health
/
7_nutrition
Asunto principal:
Retinopatía de la Prematuridad
/
Hiperglucemia
/
Enfermedades del Prematuro
Tipo de estudio:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
/
Systematic_reviews
Límite:
Female
/
Humans
/
Infant
/
Newborn
Idioma:
En
Revista:
Arch Dis Child Fetal Neonatal Ed
Asunto de la revista:
PEDIATRIA
/
PERINATOLOGIA
Año:
2022
Tipo del documento:
Article
País de afiliación:
Australia