Characteristics of dysglycemia in preterm infants and related risk factors

Objective:To explore the characteristics and regulation of dysglycemia in preterm infants,and related risk factors.Methods:Eighty-four preterm infants within 3 days of life were divided into two groups:one group weighing less than 1 500 g(30 cases) and the other weighing more than or equal to 1 500 g(54 cases).After admission,the whole blood glucose levels of all preterm infants were immediately measured using glucometer.Intravenous glucose infusion was then given at a rate of 6 mgkg-1min-1,and the glucose infusion rate was subsequently adjusted on the basis of measured glucose levels to maintain euglycemia.Insulin therapy was administered when necessary.The characteristics of dysglycemia in preterm infants and related risk factors were analysed.Results:Hypoglycemia occurred in 11 infants(13.1%) after admission.The hypoglycemia incidence was significantly higher in 1 500 g group than in 1 500 g group(26.7% vs 5.6%,P0.05).Hyperglycemia occurred in 41 infants(48.8%) after infusion of glucose.The hyperglycemia incidence was considerably higher in 1 500 g group than in 1 500 g group(73.3% vs 35.2%,P0.01).The hyperglycemia in 39 of the 41 preterm infants was controlled by gradually decreasing the glucose infusion rate.Persistent hyperglycemia(14 mmol/L) in the remaining two preterm infants was controlled by insulin treatment.Multivariate logistic regression analysis showed that birth weight less than 1 500 g(P0.05),asphyxia(P0.01),hypoxic brain damage(P0.01),and intracranial hemorrhage(P0.05) were significantly associated with hyperglycemia in preterm infants.Conclusions:Preterm infants are at high risk of dysglycemia during the first week of life,especially for very low birth weight infants,and hyperglycemia is more common than hypoglycemia.For most preterm infants,hyperglycemia can be controlled by reducing the glucose infusion rate.Weight less than 1 500 g,asphyxia,hypoxic brain damage,and intracranial hemorrhage were independent risk factors for preterm infant hyperglycemia.