Retrospective Clinical Study Of Neonatal Hypoglycemia And Brain Injury

Objective:The related factors of hypoglycemia brain injury were analyzed by comparing sex,gestational age,birth weight,lactation time,minimum threshold of hypoglycemia,duration of hypoglycemia,asphyxia,infection,maternal complications and perinatal factors(gestational hypertension,gestational diabetes mellitus,hypothyroidism,amniotic fluid contamination,premature rupture of membranes,intrauterine distress).The a EEG grading of hypoglycemia brain injury group was summarized,and the characteristics of cranial MRI in the study group were summarized.Method:The subjects were 69 newborns with gestational age more than 34 weeks and birth weight ? 1.5kg who developed hypoglycemia in the Neonatal intensive Care Unit of the first Hospital of Hebei Medical University from September 2017 to January 2020.24 cases of hypoglycemia brain injury were diagnosed as the study group and 45 cases of hypoglycemia without brain injury as the control group.The risk factors of hypoglycemia brain injury were analyzed by comparing the general clinical data and maternal factors between the two groups.T-test and chi-square test were used in univariate analysis.Multivariate Logistic regression analysis was used to analyze the selected variables.In the hypoglycemia brain injury group,a EEG examination and plain MRI scan were performed.AEEG was mainly used to analyze the activity background and whether there were epileptic changes.Results:1.The gestational ages of the study group and the control group were(37.49±1.32)weeks and(38.19±1.00)weeks,respectively,showing statistical significance(P<0.05).Birth weight and gender were not statistically significant(P>0.05).2.The duration of hypoglycemia in the study group and the control group was(12.33±7.67)h and(5.98±2.73)h.The minimum blood glucose thresholds in the study group and the control group were(1.47±0.21)mmol/L and(1.78±0.32)mmol/L,respectively.The duration of hypoglycemia and the minimum blood glucose thresholds were statistically significant(P < 0.05).There was no statistical significance in milk opening time(P>0.05).3.There were 4 cases of neonatal infection(16.67%)and 1 case of neonatal asphyxia(4.17%)in the study group,5 cases of neonatal infection(11.11%)and 7 cases of neonatal asphyxia(15.55%)in the control group,the differences were not statistically significant(P>0.05).4.There were 10 cases(41.67%)of mothers with gestational hypertension in the study group and 8 cases(17.78%)in the control group.There were 9 cases(37.5%)in the study group and 5 cases(11.1%)in the control group.In the study group,11(45.83%)foetus had intrauterine distress,and in the control group,8(17.78%)had intrauterine distress.Gestational hypertension,gestational diabetes,and intrauterine distress were statistically significant(P < 0.05).There was no statistical significance in comparing the two groups of mothers with hypothyroidism,amniotic fluid contamination,premature rupture of membranes and other factors(P>0.05).5.The results of multivariate logistic regression analysis showed that the duration of hypoglycemia was an independent factor(P < 0.05).6.No children in the study group presented with normal a EEG,16 case(66.7%)with mild a EEG and 8 case(33.3%)with severe a EEG.7.In the study group,17 patients completed a craniocerebral MRI.Of the 17 patients,7(41.2%)involved bilateral parietal and occipital lobes,and 1(5.9%)had lesions in the bilateral parietal and left occipital In 4 cases(23.5%),abnormal signals were seen in the corpus callosum pressure.In 3 cases(17.6%)of bilateral internal capsule hindlimb lesions,1 case(5.8%)had lesions in the left ventricle forefoot,and 1 case(5.8 %)Children showed abnormal white signals around the white matter on the parietal and deep ventricle triangles.Conclusions:1.Gestational age,minimum blood glucose threshold and hypoglycemia duration are risk factors related to hypoglycemia brain injury and newborn.Among them,hypoglycemia duration is an independent factor affecting the occurrence of hypoglycemia brain injury.2.Among maternal pregnancy complications and perinatal factors,g-estational hypertension,gestational diabetes,and intrauterine distress are risk factors for hypoglycemic brain injury.3.AEEG can better reflect the brain function,and abnormal a EEG is significant for the occurrence of hypoglycemia brain injury.4.The most common sites of neonatal hypoglycemic brain injury are the parietal lobe,occipital lobe,corpus callosum,internal capsule,and paraventricular white matter.