For a study, researchers sought to explore the hypothesis that neonatal hypoglycemia is related to educational performance between the ages of 9 and 10 years. A prospective cohort study of infants born at risk of hypoglycemia, ranging from mild to late preterm and term. Glucose concentrations in the blood and disguised interstitial sensors were monitored for up to 7 days. Infants with hypoglycemic episodes (blood glucose concentration 47 mg/dL [2.6 mmol/L]) were given treatment to keep their blood glucose concentration at or above 47 mg/dL. About 614 newborns were recruited between 2006 and 2010; 480 were tested between 2016 and 2020 at the age of 9 to 10 years. Hypoglycemia was defined as at least one hypoglycemic event that occurred more than 20 minutes apart, indicating the total of nonconcurrent hypoglycemic and interstitial episodes (sensor glucose concentration 47 mg/dL for 10 minutes). The primary outcome was low educational attainment, which was defined as performing below or significantly below the normal curriculum level on standardized examinations of reading comprehension or arithmetic. There were 47 secondary outcomes in all, including executive function, visual-motor function, psychosocial adaptation, and general health.

At a mean age of 9.4 (SD, 0.3) years, 480 (82%) of 587 eligible children (230 [48%] female) were examined. Children who were exposed to neonatal hypoglycemia and those who did not do not have significantly different rates of low educational achievement (138/304 [47%] vs 82/176 [48%], respectively; adjusted risk difference, 2% [95% CI, 11% to 8%]; adjusted relative risk, 0.95 [95% CI, 0.78-1.15]). Children who were exposed to neonatal hypoglycemia were significantly less likely to be rated as reading below or well below the curriculum level by teachers (68/281 [24%] vs 49/157 [31%], respectively; adjusted risk difference, 9% [95% CI, 17% to 1%]; adjusted relative risk, 0.72 [95% CI, 0.53-0.99; P=.04]). Other secondary end goals did not show a significant difference between groups. Exposure to neonatal hypoglycemia, compared to no such exposure, was not significantly linked with inferior educational attainment in mid-childhood among participants at risk of newborn hypoglycemia who were assessed and treated if necessary.