A study led by researchers at Baylor College of Medicine, Texas and the University of Arkansas for Medical Sciences recently revealed that newborns with hypoglycemia are associated with a poorer academic proficiency. The study was published in the journal JAMA Pediatrics and is entitled “Association Between Transient Newborn Hypoglycemia and Fourth-Grade Achievement Test Proficiency: A Population-Based Study.”
Hypoglycemia is defined by low blood sugar (glucose) levels. In utero, babies obtain glucose through the placenta, whereas after birth, the glucose source is the mother’s milk or formula and the baby’s own glucose production in the liver. However, glucose levels can be reduced if the baby does not produce enough glucose, or does not obtain enough from milk or formula, or if there is too much insulin in the blood. This neonatal hypoglycemia has been suggested to be linked to a poor long-term neurocognitive function.
“Low blood sugar (specifically low glucose levels, known as hypoglycemia) is important because the newborn’s brain principally uses glucose for energy,” explained the study’s lead author Dr. Jeffrey R. Kaiser in a news release. “It is well known that persistent and very low glucose levels in newborns are associated with brain damage and poor long-term development. The general feeling among neonatologists is that one single low value doesn’t make a difference at all, but no one has actually proven that. We wanted to look into this further since we had the data,”
Researchers analyzed the possible association between early newborn hypoglycemia (within the first 3 hours after birth) and a poor academic achievement. The team used clinical data from 1,395 infants, transiently hypoglycemic or with normal sugar levels, who were born in 1998 at the University of Arkansas for Medical Sciences hospital, and assessed their academic achievement in 2008 when children were in the fourth grade at the age of 10 years, namely in terms of literacy and mathematics.
They found that among the 1,395 infants, an early transient hypoglycemia was detected according to common hypoglycemia cutoff values: 6.4% of the newborns considering glucose levels lower than 35 mg/dL, 10.3% with levels lower than 40 mg/dL and 19.3% with glucose levels lower than 45 mg/dL. Transient hypoglycemia was found to be associated with a decreased literacy and mathematics test scores, where newborns with normal glucose levels were found to be around 20% more proficient in academic abilities than newborns with transient hypoglycemia.
The research team concluded that an early transient hypoglycemia in newborns was associated with a lower proficiency on literacy and mathematics test scores in the fourth grade. This finding is especially important since it is known that low fourth grade achievement scores are linked to a lower high school graduation rate, college attendance and, in the end, less long-term economic success. The authors are, however, cautious and suggest that their findings should be validated in further studies in order to establish whether a universal newborn glucose screening should be implemented.
“The hope is that now that we have shown some evidence of the impact of early transient newborn hypoglycemia, and if corroborated by other researchers, maybe we will screen for it and treat it to prevent these cognitive defects,” concluded Dr. Kaiser.