Association of early hyperglycemia with morbidity and mortality in very low birth weight infants

Abstract

Objective

To evaluate the association between hyperglycemia and morbidity/mortality in very-low-birth-weight infants.

Methods

This retrospective study analyzed 255 very-low-birth-weight infants admitted to a Neonatal Intensive Care Unit (2020–2024). Infants were stratified by glucose levels: hyperglycemia (> 150 mg/dL) vs. normoglycemia (>47 mg/dl, ≤ 150 mg/dL). Hyperglycemic infants were further categorized by duration (≤ 72 vs. >72 h) and severity (150–220 vs. ≥ 220 mg/dL). Outcomes included retinopathy of prematurity (ROP), intraventricular hemorrhage (IVH), and mortality. Logistic regression was used to assess independent associations.

Results

Hyperglycemia occurred in 44.7% (114 of 255) of infants. Compared to normoglycemic infants, hyperglycemic infants had higher incidences of ROP (p < 0.001), IVH (p < 0.001), and mortality ( p = 0.046). Logistic regression confirmed hyperglycemia as an significantly associated factor of ROP and IVH (p < 0.05) but not mortality (p = 0.777). Prolonged hyperglycemia (> 72 h) increased ROP risk (p < 0.05), while severe hyperglycemia (≥ 220 mg/dL) elevated IVH risk ( p < 0.05).

Conclusions

Hyperglycemia in very-low-birth-weight infants is associated with higher incidences of ROP and IVH, with both duration and severity influencing the risk. Strict glucose monitoring and timely intervention are crucial to reduce these complications.