Liggins Institute, University of Auckland, Auckland, New Zealand.
Kidz First Neonatal Care, Counties Manukau Health, Auckland, New Zealand.
Dev Med Child Neurol. 2023 Sep;65(9):1226-1237. doi: 10.1111/dmcn.15520. Epub 2023 Jan 31.
To examine the relationship between neonatal hypoglycaemia and specific areas of executive function and behaviour in mid-childhood.
Participants in a prospective cohort study of infants born late preterm or at term at risk of neonatal hypoglycaemia were assessed at 9 to 10 years. We assessed executive function using performance-based (Cambridge Neuropsychological Tests Automated Battery) and questionnaire-based (Behavior Rating Inventory of Executive Function) measures and behaviour problems with the Strengths and Difficulties Questionnaire. Data are reported as adjusted odds ratio (aOR) with 95% confidence intervals, and standardized regression coefficients.
We assessed 480 (230 females, 250 males; mean age 9 years 5 months [SD 4 months, range 8 years 8 months-11 years 0 months]) of 587 eligible children (82%). There were no differences in performance-based executive function between children who did and did not experience neonatal hypoglycaemia (blood glucose <2.6 mmoL/L). However, children who experienced hypoglycaemia, especially if severe or recurrent, were at greater risk of parent-reported metacognition difficulties (aOR 2.37-3.71), parent-reported peer (aOR 1.62-1.89) and teacher-reported conduct (aOR 2.14 for severe hypoglycaemia) problems. Both performance- and questionnaire-based executive functions were associated with behaviour problems.
Neonatal hypoglycaemia may be associated with difficulties in specific aspects of parent-reported executive functions and behaviour problems in mid-childhood.
研究新生儿低血糖与儿童中期特定执行功能和行为领域之间的关系。
对有发生新生儿低血糖风险的晚期早产儿或足月出生的婴儿进行前瞻性队列研究，在 9 至 10 岁时进行评估。我们使用基于表现的（剑桥神经心理学测试自动电池）和基于问卷的（执行功能行为评定量表）措施评估执行功能，使用《长处和困难问卷》评估行为问题。数据以调整后的优势比（aOR）及其 95%置信区间和标准化回归系数报告。
我们评估了 587 名符合条件的儿童中的 480 名（230 名女性，250 名男性；平均年龄为 9 岁 5 个月[SD 4 个月，范围为 8 岁 8 个月至 11 岁 0 个月]）。经历过新生儿低血糖（血糖<2.6mmol/L）的儿童与未经历过低血糖的儿童在基于表现的执行功能方面没有差异。然而，经历低血糖的儿童，尤其是严重或反复发生低血糖的儿童，更有可能出现家长报告的元认知困难（aOR 2.37-3.71）、家长报告的同伴（aOR 1.62-1.89）和教师报告的行为问题（严重低血糖的 aOR 为 2.14）。基于表现和问卷的执行功能均与行为问题相关。
新生儿低血糖可能与儿童中期特定方面的家长报告执行功能和行为问题有关。
