Prevalence and prognostic value of plasma glucose abnormalities among full-term and late-preterm neonates with sepsis

Background: Neonatal sepsis is occasionally associated with abnormal plasma glucose level, but data in full-term and late-preterm neonates is limited. Our aim was to determine prevalence and prognostic value of plasma glucose abnormalities among these patients. Results: We conducted a prospective observational study of 174 full-term and late-preterm neonates with culture-proven or possible sepsis. Plasma glucose level was measured upon neonatal intensive care unit (NICU) admission. The primary outcome was NICU mortality. Hyperglycemia occurred in 12.6%, while hypoglycemia occurred in 10.9% of infants with sepsis. The mortality rate was 36.4%, 47.4%, and 16.5% among infants with hyperglycemia, hypoglycemia, and normoglycemia respectively (P = 0.002). Both hyperglycemia and hypoglycemia were independent predictors of mortality [adjusted OR and 95% CI = 2.89 (1.03-8.13) and 3.86 (1.32-11.26) respectively]. Mechanical ventilation rate was higher among the hypoglycemia subgroup compared with both the hyperglycemia and normoglycemia subgroups (P = 0.046), but glycemic status was not associated with the length of NICU stay. Hypoglycemia was also associated with a lower platelet count (P = 0.015). Conclusion: Plasma glucose abnormalities are not uncommon in neonatal sepsis. Both hypoglycemia and hyperglycemia could be utilized for mortality prediction. Besides, hypoglycemia was associated with a higher mechanical ventilation rate. However, these associations might not be causal.