Association between elevated blood glucose level and brain injuries (IVH/WMI) in preterm infants

INTRODUCTION: The likelihood of developing preterm brain injury such as intraventricular hemorrhage (IVH) or cystic white matter injury (cWMI) largely depends on gestational age. However, its pathogenesis is multifactorial, and accounting of additional risk factors is important for preventing brain injury. Glucose is one of the most important energy sources for the brain. Both high and low blood glucose level may be associated with the onset and progression of brain disorders. METHODS: To evaluate the relation between preterm brain injury (IVH/cWMI) and blood glucose level, univariate statistical analyses of retrospective data of 109 extremely and very preterm infants was performed. The analyzed data included 14 prenatal and infant diagnoses and 32 regularly measured parameters. RESULTS: Mean values of whole blood glucose levels in preterm infants diagnosed with IVH or cWMI was higher than in controls indicating that elevated blood glucose level is associated with development of preterm brain injury. Mean values were higher both before and after diagnosis of IVH or cWMI, and even significantly exceeded the hyperglycemia threshold of 125 mg/dL following IVH diagnosis. Furthermore, a significant or moderate association was revealed between elevated blood glucose level and 8 medical diagnoses, as well as 21 routinely measured parameters. CONCLUSION: Our study emphasizes the importance of regularly monitoring blood glucose levels in preterm infants and keeping it within a safe range.