Two Preemie Treatments May Not Help

ByABC News
October 29, 2008, 9:02 PM

Oct. 30 -- WEDNESDAY, Oct. 29 (HealthDay News) -- Two therapies that looked as if they might help prevent serious complications and deaths in the smallest preterm infants have instead yielded disappointing results, studies show.

The studies -- one that examined insulin therapy and one that looked at the effects of aggressive phototherapy -- found that neither treatment was effective in reducing the risk of death, and there was even a slight increase in the death rate for the insulin treatment group. The aggressive phototherapy (light) study, however, did find a lower risk of neurodevelopmental impairments in preemie babies.

Results of both studies were published in the Oct. 30 issue of the New England Journal of Medicine.

More than 12 percent of babies in the United States are born prematurely (before 37 weeks' gestation), according to the March of Dimes, and that number has risen 30 percent since 1981. Babies born early face a host of serious medical problems, and the less developed they are at birth, generally the more problems they face.

One problem that very low birth weight babies often face is high blood glucose levels (hyperglycemia). This can lead to brain hemorrhage, and it also increases the risk of infection, explained Dr. David Dunger, senior author of the insulin study, and a professor of pediatrics at the University of Cambridge in the United Kingdom.

For adults in intensive care, controlling high glucose levels leads to better outcomes, and so, the scientists theorized that the same might hold true for infants.

The current study included 389 babies from multiple medical centers. Half of the infants were given continuous insulin infusions along with continuous dextrose [sugar] support, and the other half received standard care.

"The insulin treatment was effective in lowering glucose levels and allowing more carbohydrate to be given to the babies, resulting in less weight loss," Dunger said. "However, the treatment had no effect on morbidity or mortality and was associated with an increased risk for low blood sugars."