Dysglycaemia in Nigerian neonates with hypoxic ischemic encephalopathy

Background: To investigate the prevalence and associated outcomes of dysglycaemia in neonates with hypoxic ischemic encephalopathy (HIE).  Methods: This was a retrospective analysis of neonates with HIE over one year.  The point of admission blood glucose level was measured. Dysglycaemia is defined as a blood glucose level <45 mg/dl or >145 mg/dl, and its association with short-term outcomes was determined. Results: Dysglycaemia was observed in 4/22(18%) of the neonates with stage 1 HIE, 6/32 (28.1%), and 1/5(20%) with stage 3 (p>0.05). Thirty-eight neonates survived, while 21 (35.6%) died. Death was observed in 15 (33.3%) normoglycemic neonates, and 6/14 (42.9%) with dysglycaemia (p>0.05). After controlling for birth weight, hypothermia, hypoxia, and HIE stage, dysglycaemia was not significantly related to mortality (AOR=0.64, 95% CI= 0.16–2.63, p=0.537). Conclusions: Dysglycaemia occurred in about one in four neonates with HIE. They were associated with higher mortality, though the association was not significant. Continuous glucose monitoring during treatment of asphyxiated neonates will enable early detection and prompt treatment of glucose alterations, thereby improving outcomes. Expanding access to advanced neuroprotective care, such as therapeutic hypothermia, could further reduce mortality in similar settings.