DOI: http://dx.doi.org/10.18203/2349-3291.ijcp20210126

Clinical profile of hypoglycemia in neonates admitted in neonatal intensive care unit of a tertiary care hospital

Sayooj Somanathan, Sriram Pothapregada, Anuradha Varadhan, Ruth Ann Mathew

Abstract


Background: This study was conducted to study the clinical profile of hypoglycemia in newborn and to determine the prevalence of hypoglycemia among neonates admitted in NICU.

Methods: All newborns admitted in NICU were examined and those with hypoglycemia (GMR<45 mg/dl) were included in the study and observed. In neonates with risk factors blood sugar was screened at 2, 6, 12, 24, 48 and 72 hours of life or whenever symptoms suggestive of hypoglycemia developed in any neonates and for critically sick neonates blood sugar was screened in every 6 hour in active phase of illness. Any neonates with blood glucose level less than 45 mg/dl were analysed for maternal risk factors, neonatal risk factors and course in the NICU.

Results: The prevalence of neonatal hypoglycemia was 14.9% among NICU admissions. The maternal risk factors were GDM, PIH, and PROM. The neonatal risk factors were prematurity, SGA, LGA and comorbid conditions which include perinatal asphyxia, sepsis, polycythemia, shock. The common symptoms were poor feeding, lethargy, jitteriness, convulsions, irritability, hypotonia and cyanosis. Majority of the neonates required only oral feeds for correction of hypoglycemia.

Conclusions: Blood glucose screening in neonates with this risk factor is mandatory as many of the neonates were asymptomatic. The importance of early initiation of breast feeding to prevent hypoglycemia should be emphasized. 


Keywords


Clinical profile, Hypoglycemia, Neonates, Prevalence, Risk factors

Full Text:

PDF

References


Schaefer-Graf UM, Rossi R, Bührer C, Siebert G, Kjos SL, Dudenhausen JW, et al. Rate and risk factors of hypoglycemia in large-for-gestational-age newborn infants of nondiabetic mothers. Am J Obstet Gynecol. 2002;187(4):913-7.

Cole MD, Peevy K. Hypoglycemia in normal neonates appropriate for gestational age. J Perinatol. 1994;14(2):118-20.

Heck LJ, Ehrenberg A. Serum glucose levels in term neonates during the first 48 hours of life. J Pediatr. 1987;110(1):119-22.

Cornblath M, Hawdon JM, Williams AF. Controversies regarding definition of neonatal hypoglycemia: suggested operational thresholds. Pediatrics. 2000;105:1141-5.

Sexson WR. Incidence of neonatal hypoglycemia: a matter of definition. J Pediatr. 1984;105(1):149-50.

Zhou W, Yu J, Wu Y, Zhang H. Hypoglycemia incidence and risk factors assessment in hospitalized neonates. J Matern Fet Neonat Med. 2015;28(4):422-5.

Kalhan S, Peter-Wohl S. Hypoglycemia: what is it for the neonate? Am J Perinatol. 2000;17(01):011-8.

Harris DL, Weston PJ, Harding JE. Incidence of neonatal hypoglycemia in babies identified as at risk. J Pediatr. 2012;161(5):787-91.

Williams A. World Health Organization. Hypoglycemia of the Newborn: Review of the Literature. World Health Organization, Geneva. 1997. Available from: https://www.who.int/maternal_child_adolescent/documents/chd_97_1/en/. Accessed on 16 August 2018.

Charles AS, Eugina KP. Disorders of carbohydrate metabolism. In: Teuscch HW, Ballard RA, Gleason CA, eds. Avery Disease of the Newborn. 8th ed. Philadelphia: Saunders; 2005:1410-1420.

Kliegman RM. Problems in metabolic adaptation: glucose, calcium, and magnesium. In care of the high-risk neonate. 2001;301.

Barbara JS, Robert MK. The endocrine system. In: Behrman RE, Kliegman RM, Jenson HB, eds. Nelson Text Book of Pediatrics. 20th edn. Philadelphia: Saunders; 2016:614-616.

Tam EW, Haeusslein LA, Bonifacio SL, Glass HC, Rogers EE, Jeremy RJ, et al. Hypoglycemia is associated with increased risk for brain injury and adverse neurodevelopmental outcome in neonates at risk for encephalopathy. J Pediatr. 2012;161(1):88-93.

Platt MW, Deshpande S. Metabolic adaptation at birth. Semin Fet Neonat Med. 2005;10(4):341-50.

Dean AG, Sullivan KM, Soe MM. Open Epi: Open Source Epidemiologic Statistics for Public Health, Version 3.01. Availabl from: https://www.openepi.com/Menu/OE_Menu.htm. Accessed on 16 August 2018.

Dhananjaya CD, Kiran B. Clinical profile of hypoglycemia in newborn babies in a rural hospital setting. Int J Biol Med Res. 2011;2(4):1110-4.

Singh K, Kher AM. Clinico-biochemical profile of hypoglycemia in neonates admitted in NICU. Int J Contemp Pediatr. 2019;6(1):1.

Babu MR, D’Souza JL, Susheela C. Study of incidence, clinical profile and risk factors of neonatal hypoglycemia in a tertiary care hospital. Int J Pediatr Res. 2016;3(10):753.

Singhal PK, Singh M, Paul VK, Deorari AK, Ghorpade MG, Malhotra A. Neonatal hypoglycemia--clinical profile and glucose requirements. Indian Pediatr. 1992;29(2):167-71.

Amarendra M, Sethi RK, Pericherla VP. Incidence of hypoglycemia within 72 hours after birth in low birth weight babies who are appropriate for gestational age. Int J Contemp Paediatr. 2018;5(3):944.

Anjum R, Anjum R, Qayum S. Neonatal hypoglycemia: risk factors and clinical profile. J Med Sci Clin Res. 2019;7(2):1081-5.

Holtrop PC. The frequency of hypoglycemia in full-term large and small for gestational age newborns. Am J Perinatol. 1993;10(02):150-4.

Sasidharan CK, Gokul E, Sabitha S. Incidence and risk factors for neonatal hypoglycemia in Kerala, India. Ceylon Med J. 2010;49(4).