Childhood Outcomes after Dextrose Gel for Treating and Preventing Low Glucose Levels in Babies

Oral dextrose gel effectively treats and prevents neonatal hypoglycaemia, but its long-term benefits and harms remain unclear. This thesis aimed to investigate childhood outcomes after oral dextrose gel to treat and prevent neonatal hypoglycaemia in late preterm and term at-risk infants. We updated two Cochrane Reviews to assess the effectiveness of oral dextrose gel in treating and preventing neonatal hypoglycaemia and reducing long-term neurodevelopmental impairment. We performed a prospective follow-up of the hypoglycaemia Prevention with Oral Dextrose (hPOD) multicentre, double-blinded randomised trial to assess the effects of prophylactic oral dextrose gel compared with placebo gel on neurocognitive, growth and health outcomes at 2 years’ corrected age and tested the robustness of these findings. We conducted an exploratory analysis of the hPOD trial cohort to examine relationships between neonatal hypoglycaemia and neurocognitive outcomes at 2 years’ corrected age. Two Cochrane Reviews showed that compared with placebo gel, oral dextrose gel effectively treated and prevented neonatal hypoglycaemia in late preterm and term infants born at risk of neonatal hypoglycaemia. Compared with placebo gel, oral dextrose gel treatment and prophylaxis also reduced major neurological disability at 2 years of age or older. In contrast, the hPOD study showed that compared with placebo gel, prophylactic oral dextrose gel did not alter the risk of neurosensory impairment at 2 years’ corrected age but increased the risk of motor delay and resulted in lower Bayley- III cognitive and motor scores. In the exploratory cohort analysis, children who experienced neonatal hypoglycaemia were more likely to have neurosensory impairment at 2 years’ corrected age compared with those who did not experience hypoglycaemia. Oral dextrose gel is an effective first-line treatment for neonatal hypoglycaemia in late preterm and term infants born at risk of neonatal hypoglycaemia. The effects of oral dextrose gel on childhood outcomes may be different when used as treatment compared with prophylaxis. Prophylactic oral dextrose gel may be associated with later harm and should not yet be considered for introduction into clinical practice. Brief transitional neonatal hypoglycaemia is associated with poorer neurodevelopment at 2 years’ corrected age, but causal relationships remain unclear.

Name thesis:degree_name

PhD

Level thesis:degree_level

Doctoral

Discipline thesis:degree_discipline

Perinatal Science

Grantor dc:publisher

ResearchSpace@Auckland

Year dc:date.issued

2022

Author dc:creator

• Edwards, Taygen Shirley

Advisors dc:contributor.advisor

• Harding, Jane
• Gamble, Greg
• McKinlay, Chris

Statement dc:rights

• Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated.

Licence dc:rights.uri

• https://researchspace.auckland.ac.nz/docs/uoa-docs/rights.htm

Handle dc:identifier.uri

https://hdl.handle.net/2292/64685

OAI identifier oai:identifier

oai:researchspace.auckland.ac.nz:2292/64685