DOI: http://dx.doi.org/10.18203/2349-3291.ijcp20183538

Incidence of hypoglycemia in newborns with risk factors

Thinesh Kumar J., Vaideeswaran M., Arasar Seeralar T.

Abstract


Background: The incidence of hypoglycemia varies worldwide according to the protocols and feeding Policies. There is paucity of data on Incidence of hypoglycemia in institutions where exclusive breastfeeding is followed. Objectives of this study was to study the incidence of hypoglycemia in newborns with risk factors and to study the differences in incidence between at risk groups.

Methods: The Observational study was conducted in babies born with risk factors for hypoglycemia, infant of diabetic mother (IGDM/IDM), LGA (birthweight >90th percentile), SGA (birth weight <10th percentile), low birth weight (>1800 to <2500 grams) and preterm (35 - 37 weeks). babies on formula or pre-lacteal feed, major congenital malformations and admitted in NICU for other reasons were excluded. Hypoglycemia screening was done at 2, 6, 12, 24 and 48 hours of life, prior to feeding.

Results: The incidence of hypoglycemia in newborns with risk factors was 33.3%. Out of 1883 Babies born with risk factors, 627 Babies developed at least one episode of hypoglycemia. Of these, 576 (30.3%) were asymptomatic hypoglycemia and 51 (3.0%) symptomatic hypoglycemia. Hypoglycemia was seen in 42% of SGA, 33% of IDM, 19% of preterm and 10% of LGA babies. About 51% of newborns developed hypoglycemia at 2 hours of life and about 31% of newborns at 6 hours of life. No hypoglycemic episodes were noted after 24 hours of life.

Conclusions: Hypoglycemia screening should be done at regular interval, more specifically at first 24 hours of life in at risk babies where Exclusive Breastfeeding is followed.


Keywords


Incidence, Hypoglycemia, Newborns, Risk factors

Full Text:

PDF

References


Harris DL, Weston P, Harding JE. Incidence of neonatal hypoglycemia in babies identified as at risk. J Pediatr. 2012;161:787e91.

Kahler SG. Metabolic disorders associated with neonatal hypoglycemia. Neo Rev. 2004;5.

Kalhan SC, D'Angelo L, Savin SM, Adam PAJ. Glucose production in pregnant women at term gestation: Sources of glucose for human fetus. J Clin Invest. 1979; 63:388-94.

Srinivasan G, Pildes RS, Cattamanchi G, Voora S, Lilien LD. Plasma glucose values in normal neonates: a new look. J Pediatr. 1986;109:114-7.

Heck LJ, Erenberg A. Serum glucose levels in term neonates during the first 48 h of life. J Pediatr. 1987;110:119e22.

Adamkin DH. Update on neonatal hypoglycemia. ArchsPerinat Med. 2005;11:13e5.

Lucas A, Morley R. Outcome of neonatal hypoglycemia. Br Med J. 1999;318:194.

Filan PM, Inder TE, Cameron FJ. Neonatal hypoglycemia and occipital cerebral injury. J Pediatr. 2006;148:552-5.

Deshpande S, Ward Platt M. The investigation and management of neonatal hypoglycaemia. Semin Fetal Neonatal Med. 2005;10:351-61.

Rozance PJ, Limesand SW, Barry JS. Chronic late gestation hypoglycemia up-regulates hepatic PEPCK associated with Increased PGC1α mRNA and pCREB in fetal sheep. Am J Physiol Endo Metab. 2007;294:E365-70.

Kaiser JR, Bai S, Gibson N. Association between transient neonatal hypoglycemia and fourth-grade achievement test proficiency. A population-based study. JAMA Pediatr. 2015;169(10):913-21.

Smolkin T, Ulanovsky I, Carasso P. Standards of admission capillary blood glucose levels in cesarean born neonates. World J Pediatr. 2017;13(5):433-8.

DePuy AM, Coassolo KM, Som DA. Neonatal hypoglycemia in term, nondiabetic pregnancies. Am J Obstet Gynecol. 2009;200(5):e45-e51.

Singh P, Upadhyay A, Sreenivas V, Jaiswal V, Saxena P. Screening for hypoglycemia in exclusively breastfed high-risk neonates. Indian pediatrics. 2017;54(6):477-80.

Holtrop PC. The frequency of hypoglycemia in full term large and small for gestational age newborns. Am J Perinatol. 1993;10:150-64.

Bhat MA, Kumar P, Bhansali A, Majumdar S, Narang A. Hypoglycemia in small for gestational age babies. Indian J Pediatr. 2000;67:4.

De AK, Biswas R, Samanta M, Kundu CK. Study of blood glucose level in normal and low birth weight newborns and impact of early breast-feeding in a tertiary care Centre. Ann Nigerian Med. 2011;5:53-8.

Saini A, Gaur BK, Singh P. Hypoglycemia in low birth weight neonates: frequency, pattern, and likely determinants. Int J Contemp Pediatr. 2018;5(2):526-32.

Cordero L, Thung S, Landon MB, Nankervis CA. Breast-feeding initiation in women with pregestational diabetes mellitus. Clinical Pediatr. 2014;53(1):18-25.