Study of hypoglycemia in neonates with low birth weight
Abstract
Background: Glucose metabolism disorders are common in low birth weight (LBW) infants and are associated with high morbidity and mortality. Neonatal hypoglycemia, a common metabolic problem, often goes unnoticed owing to a lack of specific symptoms. Hypoglycemia both symptomatic and asymptomatic can lead to long term neurological sequelae. Therefore, it needs early management to prevent brain damage in a developing neonate.
Objective: This study was conducted to evaluate the prevalence and risk factors associated with hypoglycemia in low birth weight infants.
Design: A hospital-based prospective longitudinal study.
Duration: One year (October 2017-October 2018).
Setting: Niloufer Hospital, Hyderabad.
Participants: 50 LBW neonates with birth weight less than 2500 grams.
Methods: Blood glucose values were measured at the age of 1 h, 6 h, 12 h, 24 h, and 48 h after delivery which was independent of feeding time. Blood glucose value of less than 40 mg/dl (2.2 mmol/l) was defined as hypoglycemia. For statistical analysis, SPSS software version 20 was used.
Results: Out of 50 neonates, 15 (30%) had one or more episodes of hypoglycemia. Overall 22 episodes were recorded. Out of 15 hypoglycemic neonates, 8 (53.3%) were small for gestational age (SGA) and 7 (46.7%) were AGA. Sepsis was significantly noticed after hypoglycemia. The pattern of blood glucose levels was significantly different among hypoglycemic babies and normoglycemic babies over the first 72 hours.
Conclusion: Hypoglycemia was frequent among low birth weight babies more so in SGA babies in the first 24 hours.
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References
World Health Organization. Division of Child Health and Development and World Health Organization. Maternal Health and Safe Motherhood Programme. (1997). Hypoglycaemia of the newborn : review of the literature. World Health Organization. https://apps.who.int/iris/handle/10665/63362.
Ktorza A, Bihoreau MT, Nurjhan N, Picon L, Girard J. Insulin and glucagon during the perinatal period: secretion and metabolic effects on the liver. Neonatology. 1985;48(4):204-220. doi: https://doi.org/10.1159/000242173.
Adamkin DH. Postnatal Glucose Homeostasis in Late preterm and term infants. A clinical report from American Academy of Pediatrics, Committee on Fetus and Newborn Pediatrics. Pediatr. 2011;127(3):575-579. doi: https://doi.org/10.1542/peds.2010-3851.
Barbara J. Stoll. The Endocrine System. Nelson Textbook of Pediatrics. 18th ed., vol. 1. Part XI, Chapter 107. Mosby, Churchill Livingstone: Elsevier Saunders; 2007. p. 782-785.
Hawdon JM, Ward Platt MP, Aynsley-Green A. Patterns of metabolic adaptation for preterm and term infants in the first neonatal week. Arch Dis Child. 1992;67(4 Spec No):357-365. doi: https://dx.doi.org/10.1136%2Fadc.67.4_spec_no.357.
Hewitt V, Watts R, Robertson J, Haddow G. Nursing and midwifery management of hypoglycaemia in healthy term neonates. Int J Evid‐Based Healthc. 2005;3(7):169-205. doi: https://dx.doi.org/10.1111/j.1479-6988.2005.00025.x.
Hoseth E, Joergensen A, Ebbesen F, Moeller M. Blood glucose levels in a population of healthy, breast fed, term infants of appropriate size for gestational age. Arch Dis Child Fetal Neonatal Ed. 2000;83(2):F117-F119. doi: https://dx.doi.org/10.1136/fn.83.2.f117.
Dias E, Gada S. Glucose levels in newborns with special reference to hypoglycemia: a study from rural India. J Clin Neonatol. 2014;3(1):35-8. doi: https://dx.doi.org/10.4103/2249-4847.128729.
Jonas D, Dietz W, Simma B. Hypoglycemia in newborn infants at risk. Klin Padiatr. 2014;226(5):287-291. doi: https://dx.doi.org/10.1055/s-0034-1385928. Epub 2014 Aug 25.
Yoon JY, Chung HR, Choi CW, et al. Blood glucose levels within 7 days after birth in preterm infants according to gestational age. Ann Pediatr Endocrinol Metab. 2015;20(4):213-219. doi: https://dx.doi.org/10.6065/apem.2015.20.4.213. Epub 2015 Dec 31.
Dashti N, Einollahi N, Abbasi S. Neonatal hypoglycemia: prevalence and clinical manifestations in Tehran children’s hospital. Pakistan J Med Sci Online. 2007;23(3):340-343.
Singhal PK, Singh M, Paul VK. Prevention of hypoglycemia. A controlled evaluation of sugar fortified feeding in small for date infants. Indian Pediatr. 1992;29:1365-1369.
Anderson S, Shakya KN, Shrestha LN, de L Costello AM. Hypoglycemia: A common problem among uncomplicated newborn infants in Nepal. J Trop Pediatr. 1993;39(5):273-277. doi: https://doi.org/10.1093/tropej/39.5.273.
Holtrop PC. The frequency of hypoglycemia in full-term large and small for gestational age newborns. Am J Perinatol. 1993;10(2):150-154. doi: https://doi.org/10.1055/s-2007-994649.
Srinivasan G, Pildes RS, Cattamanchi G, Voora S, Lilien LD. Plasma glucose values in normal neonates: a new look. J Pediatr. 1986;109(1):114-117. doi: https://doi.org/10.1016/s0022-3476(86)80588-1.
Bhat MA, Kumar P, Bhansali A, Majumdar S, Narang A. Hypoglycemia in small for gestational age babies. Indian J Pediatr. 2000;67(6):423-427. doi: https://doi.org/10.1007/BF02859459.
Lubchenco LO, Bard H. Incidence of hypoglycemia in newborn infants classified by birth weight and gestational age. Pediatr. 1971;47(5):831-838.
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