A comparative study of blood glucose and serum calcium levels in term IUGR neonates and normal neonates: a cross sectional study

Kavitha Konded, Bhavana Koppad


Background: Hypoglycemia and hypocalcemia are common metabolic problems occurring in the newborn and have direct consequences in the early neonatal period, prompt identification and treatment prevents severe neurodevelopmental outcomes. The primary objective was to compare blood glucose and serum calcium levels in term Intrauterine growth restriction (IUGR) babies with term appropriate for age (AGA) babies and secondarily to compute number of term IUGR babies with hypoglycemia and hypocalcemia.

Methods: Fifty term IUGR and 50 term AGA babies delivered at SDMCMSH, Dharwad during the study period of one year were included as cases and controls respectively after considering the inclusion and exclusion criteria. Two ml of peripheral venous blood was analyzed at 3 hours and 24 hours of life. Serum calcium was measured by calorimetric test method and blood glucose by auto analyzer. Statistical analysis was done using SPSS-17.

Results: At 3 hours of birth, 24% of term IUGR and 4% of AGA neonates had hypoglycemia. The mean RBS of cases at 3rd hour was 61.36±23.56 mg/dl, significantly lower than control group (75.90±22.57mg/dl). The mean RBS among cases at 24 hours of life was 70.42±16.14 mg/dl compared to 78.84±15.90 mg/dl among controls. Both correlations were statistically significant. 8% cases had hypocalcemia at 3 hours and 6% had at 24 hours. The mean serum calcium level was lower in cases (8.50±1.40 mg/dl) than controls (8.63±1.14 mg/dl) at the 3rd hour of life and 24 hours of life [cases (8.42±1.07 mg/dl) versus controls (8.64±0.91 mg/dl)].

Conclusions: Significantly lower blood glucose levels were identified in term IUGR neonates. This association was apparent at 3 hours of life. The measurement of serum calcium & glucose in IUGR babies could predict a poorer outcome in these patients. Identifying and treating these biochemical abnormalities can avoid short term as well as long term sequelae.


AGA, Hypoglycemia, Hypocalcemia, IUGR

Full Text:



United Nations Childrens Fund and World Health Organization. Low Birthweight: Country, regional and global estimates. UNICEF, New York. 2004. Available at

Teberg AJ, Walther FJ, Pena IC. Mortality, morbidity, and outcome of the small-for-gestational age preterm infant. Semin Perinatol. 1988;12:84-94.

Fafoula O, Alkhayyat H, Hussain K. Prolonged hyperinsulinaemic hypoglycaemia in newborns with intrauterine growth retardation. Arch Dis Child Fetal Neonatal Ed. 2006;91:F467

Jain A, Aggarwal R, Sankar MJ. Hypoglycemia in the Newborn. Symposium on AIIMS protocols in neonatology-. Indian J Pediatr. 2010;77:1137-42

Jain A, Aggarwal R, Sankar MJ. Hypocalcemia in the Newborn. Symposium on aiims protocols in neonatology-I. Indian J Pediatr. 2010;77:1123-8.

Lantzy A. Merck Manual; Neonatal Hypocalcemia. 2015. Available at,-electrolyte,-and-toxic-disorders-in-neonates/neonatal-hypocalcemia

Jain A, Agarwal R, Sankar MJ, Deorari AK, Paul VK. Hypocalcemia in the newborn. Indian J Pediatr. 2008;75(2):165-9.

Mazumder MW. Study of blood glucose and serum calcium level in small for gestational age babies. J Shaheed Suhrawardy Med Coll. 2012;4(2):50-2.

Williams RI, Creasy RK, Tashiru MS. Foetal growth and perinatal viability in California. Obstet Gynecol. 1990;59:624-7.

Salle BL, Delvin E, Glorieux F, David L. Human neonatal hypocalcemia. Biol Neonate. 1990;58(1):22-31.

Su J, Wang L. Research advances in neonatal hypoglycemic brain injury. Translational Pediatr. 2012;1(2):108-15.

Rozance PJ, Hay WW. New approaches to management of neonatal hypoglycemia. Maternal Health Neonatol Perinatol. 2016;2:3.

Hasmasanu MG, Bolboaca SD, Baizat MI, Drugan TC, Zaharie GC. Neonatal short-term outcomes in infants with intrauterine growth restriction. Saudi Med J. 2015;36(8):947-53.

Lubchenco, Bard H. Incidence of hypoglycemia in newborn infants classified by birth weight and gestational age. Pediatr. 1971;47(5):831-8.

Bhat MA, Kumar P, Bhansali A, Majumdar S, Narang A. Hypoglycemia in Small for Gestational Age Babies. Indian J Pediatr. 2000;67(6):423-7.

Blaga LD. are low birth weight infants at risk for mineral disturbance in early neonatal period? Pediatr Res. 2011;70:622.

Zubair DS, Gour SS. Comparison of outcome in IUGR and normal pregnancies: a retrospective study. Int J Med Res Rev. 2016;4(4):646-9.

Tsang RC, Gigger M, Oh W, Brown DR. Studies in calcium metabolism in infants with intrauterine growth retardation. J Pediatr. 1975;86(6):936-41.