Hypoglycemia in low birth weight neonates: frequency, pattern, and likely determinants

Aanchal Saini, Bablu Kumar Gaur, Parvinder Singh


Background: Hypoglycemia is the commonest metabolic disorder of neonates. If not detected in time, it can lead to considerable morbidity and mortality. 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. The objective to study the frequency and pattern of hypoglycemia in low birth weight neonates (LBW) and the factors associated with hypoglycemia.

Methods: All neonates less than 2500 gm were carefully examined, and a detailed antenatal, natal and postnatal history was obtained. The measurement of blood glucose was estimated by glucometer by taking blood sample by prewarmed heel prick and the same time venous blood sample was sent for laboratory confirmation by glucose oxidase method. Blood glucose was estimated by glucometer at 0, 1, 2, 3, 6 and every 6 hours till 72 hours and the clinical profile of these neonates was recorded.

Results: Out of 50 neonates, 12 (24%) had one or more episode of hypoglycemia overall 20 episodes were recorded 15(75%) in first 24 hours and 5(25%) between 49-72 hours all the episodes were asymptomatic. Out of 12 hypoglycemic neonates 7 (58.3%) were small for gestational age (SGA) and 5 (41.7%) were AGA (P = ns). Sepsis was significantly noticed after hypoglycemia (p = 0.00). The pattern of blood glucose levels was significantly different among hypoglycemic babies and normoglycemic babies over first72 hours.

Conclusions: Hypoglycemia was frequent among low birth weight babies more so in SGA babies in first 24 hours.


Hypoglycemia, Low birth weight newborn, Small for gestational age

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World Health Organization, International statistical classification of diseases and related health problems' tenth revision. World Health Organization, Geneva; 1992.

Singh M. Care of the new-born. 8th ed. New Delhi: CBS Publishers; 2015:299-18.

Cloherty JP, Eichenward EC, Hansen AR, Stark AR. Manual of neonatal care. 7th ed. New Delhi; 2011:340.

American academy of paediatrics. Issue guide for neonatal hypoglycaemia. 2011.

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.

Jonas D, Dietz W, Simma B. Hypoglycemia in newborn infants at risk. Klin Pediatr. 2014;226(5):287-91.

Yoon JY, Chung HR, Choi CW, Yang SW, Kim BI. Blood glucose levels within 7 days after birth in preterm infants according to gestational age. Ann Pediatr Endocrinol Metab. 2015;20(4):213-9.

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):340-3.

Budhathoki S, Poudel P, Bhatta NK, Singh RR, Shrivastava MK, Niraula SR, et al. Clinic epidemiological study of low birth weight newborns in eastern part of Nepal. Nepal Med Coll J. 2014;16(2-4):190-3.

Burdan DR, Botiu V, Teodorescu D. Neonatal hypoglycemia. The incidence of the risk factors in savatorvuia obstetrics gynecology hospital, Arad. Timisoara Med J. 2009;59(78):5.

Hawdon JM, Beer J, Sharp D. Neonatal hypoglycemia: learning from claims. Arch Dis Child Fetal Neonatal Ed. 2016:2016

Shrestha S, Dangol SS, Shrestha M, Shrestha RP. Outcome of preterm babies and associated risk factors in a hospital. JNMA. 2010;50(180):286-90.

Simchen MJ, Weisz B, Zilberberg, Morag I, Weissmann-Brenner A, Sivan E. Male disadvantage for neonatal complications of term infants, especially in small for gestational age neonates. J Matern Fetal Neonatal Med. 2014;27(8):839-43.

Narayan S, Aggarwal R, Deorari AK, Paul VK. Hypoglycemia in the newborn. Indian J Pediatr. 2008;75(1):63-7.

Kayiran SM, Gurakan B. Screening of blood glucose levels in healthy neonates. Singapore Med J. 2010;51(11):853.

Tenovuo A. Neonatal complications in small for gestational age neonates. J Perinat Med. 1988;16(3):197-203.

Holtrop PC. The frequency of hypoglycemia in full term large and small for gestational age newborns. Am J Perinatol. 1993;10(2):150-4

Karahasanoglu O, Karatekin G, Kose R, Nuhoglu A. Hypoglycemia in small for gestational age neonates. Turk J Pediatr. 1997;39(2):159-64.

Wright LL, Stanley CA, Anday EK, Baker L. The effect of early feeding on plasma glucose levels in SGA infants. ClinPediatr (Phila). 1983;22(8):539-41.

Staffler A, Klemme M, Mola-Schenzle E, Mittal R, Schulze A, Flemmer AW. Very low birth weight preterm infants are at risk for hypoglycemia once on total enteral nutrition. J Matern Fetal Neonatal Med. 2013;26(13):1337-41.

Maayan MA, Lubin D, Kuint J. Hypoglycemia rates in the first days of life among term infants born to diabetic mothers. Neonatol. 2009:96(2):80-5.

Adamkin DH. Late preterm infants: severe hyperbilirubinemia and postnatal glucose homeostasis. J Perinatol. 2009;29(2):S12-7.

Samayam P, Ranganathan PK, Kotari UD, Balasundaram R. Study of asymptomatic hypoglycemia in full term exclusively breastfed neonates in first 48 hours of life. J Clin Diagn Res. 2015;9(9):SC07-10.