{
  "abstract": "Objectives To assess in newborns with neonatal encephalopathy (NE), presumptively related to a peripartum hypoxic-ischemic event, the frequency of dysglycemia and its association with neonatal adverse outcomes. Study design We conducted a secondary analysis of LyTONEPAL (Long-Term Outcome of Neonatal hypoxic En-cePhALopathy in the era of neuroprotective treatment with hypothermia), a population-based cohort study including 545 patients with moderate-to-severe NE. Newborns were categorized by the glycemia values assessed by routine clinical care during the first 3 days of life: normoglycemic (all glycemia measurements ranged from 2.2 to 8.3 mmol/L), hyperglycemic (at least 1 measurement >8.3 mmol/L), hypoglycemic (at least 1 measurement <2.2 mmol/L), or with glycemic lability (measurements included at least 1 episode of hypoglycemia and 1 episode of hyperglycemia). The primary adverse outcome was a composite outcome defined by death and/or brain lesions on magnetic resonance imaging, regardless of severity or location. Results In total, 199 newborns were categorized as normoglycemic (36.5%), 74 hypoglycemic (13.6%), 213 hyperglycemic (39.1%), and 59 (10.8%) with glycemic lability, based on the 2593 glycemia measurements collected. The primary adverse outcome was observed in 77 (45.8%) normoglycemic newborns, 37 (59.7%) with hypoglycemia, 137 (67.5%) with hyperglycemia, and 40 (70.2%) with glycemic lability (P < .01). With the normoglycemic group as the reference, the aORs and 95% 95% CIs for the adverse outcome were significantly greater for the group with hyperglycemia (aOR 1.81; 95% CI 1.06-3.11). Conclusions Dysglycemia affects nearly two-thirds of newborns with NE and is independently associated with a greater risk of mortality and/or brain lesions on magnetic resonance imaging. (J Pediatr 2023;-:1-8). Trial registration NCT02676063 A meta-analysis has demonstrated the effectiveness of therapeutic hypothermia in reducing the risk of death and neurologic damage in newborns with neonatal encephalopathy (NE), presumptively related to a hypoxic-ischemic peripartum event, 1 and led to its widespread use in developed countries. 2,3 Nevertheless, a large proportion-approximately 46%-of treated patients will die or develop moderate or severe disabilities. 1 Among the mechanisms of neuroprotection, those preventing secondary cerebral insults of systemic origin could improve outcomes, 4,5 as described for other patients with brain injuries with hypotension, hypertension, 6 and inadequate metabolic homeostasis. 7 Hypoglycemia is reported to exacerbate asphyxia-induced neonatal brain damage in animal studies as well as in preclinical and clinical studies in humans. 8,9 Results about the effects of hyperglycemia on clinical outcomes conflict. 10-12 All of these findings, nonetheless, come from trials and single-center studies and require further confirmation before changes in the routine management of patients treated for NE can be recommended. The LyTONEPAL (Long-Term Outcome of Neonatal hypoxic EncePhALopathy in the era of neuroprotective treatment with hypothermia) cohort study 13 is a large prospective, nationwide, population-based cohort in France including newborns with NE in routine care and full access to therapeutic hypothermia. 14 We",
  "abstract_shown": true,
  "affiliations": [],
  "article_type": null,
  "arxiv": null,
  "author_total": 11,
  "authors": [
    {
      "name": "Isabelle Guellec"
    },
    {
      "name": "Pierre-Yves Ancel"
    },
    {
      "name": "Jonathan Beck"
    },
    {
      "name": "Gauthier Loron"
    },
    {
      "name": "Marie Chevallier"
    },
    {
      "name": "Véronique Pierrat"
    },
    {
      "name": "Gilles Kayem"
    },
    {
      "name": "Antoine Vilotitch"
    },
    {
      "name": "Olivier Baud"
    },
    {
      "name": "Anne Ego"
    },
    {
      "name": "Thierry Debillon"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/7z2xt0n1maaes.bib",
  "cited_by": 29,
  "doi": "10.1016/j.jpeds.2023.02.003",
  "fulltext_url": null,
  "id": "7z2xt0n1maaes",
  "issns": [
    "0022-3476",
    "1097-6833"
  ],
  "landing_url": "https://hal.science/hal-05762650v1",
  "language": "en",
  "licence": "CC-BY-ND-4.0",
  "licence_label": "CC BY-ND 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "hal",
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    [
      "openalex",
      "2735|Neonatal and fetal brain pathology"
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  "openalex": "W4321483500",
  "pdf_url": "https://hal.science/hal-05762650/document",
  "pmcid": null,
  "pmid": null,
  "published": "2026-10-02",
  "publisher": "Elsevier",
  "ris": "https://research.draconitic.com/paper/7z2xt0n1maaes.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:17:40Z",
      "native_id": "hal-05762650",
      "source": "hal",
      "url": "https://hal.science/hal-05762650v1"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2735|Neonatal and fetal brain pathology",
      "subfield": "reproductive-child"
    }
  ],
  "title": "Glycemia and Neonatal Encephalopathy: Outcomes in the LyTONEPAL (Long-Term Outcome of Neonatal Hypoxic EncePhALopathy in the Era of Neuroprotective Treatment With Hypothermia) Cohort",
  "title_text": "Glycemia and Neonatal Encephalopathy: Outcomes in the LyTONEPAL (Long-Term Outcome of Neonatal Hypoxic EncePhALopathy in the Era of Neuroprotective Treatment With Hypothermia) Cohort",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:17:40Z",
  "url": "https://research.draconitic.com/paper/7z2xt0n1maaes",
  "venue": "The Journal of Pediatrics",
  "versions": []
}