Study of incidence, risk factors and immediate outcome of hypoglycemia in neonates admitted in NICU

Authors

  • Aatif Ansari Department of Paediatrics, Dr. V. M. Govt. Medical College, Solapur, Maharashtra, India
  • S. V. Savaskar Department of Paediatrics, Dr. V. M. Govt. Medical College, Solapur, Maharashtra, India
  • Moin Tamboli Department of Paediatrics, Dr. V. M. Govt. Medical College, Solapur, Maharashtra, India
  • Pushpa S. N. Department of Paediatrics, Dr. V. M. Govt. Medical College, Solapur, Maharashtra, India

DOI:

https://doi.org/10.18203/2349-3291.ijcp20232253

Keywords:

Neonates, Hypoglycemia, Incidence, Risk factors, Screening, Outcomes

Abstract

Background: Hypoglycemia is the most common metabolic problem occurring in newborns which is associated with poor neurologic outcome. The present study was conducted to determine the incidence, risk factors and immediate outcome of hypoglycemia in neonates.

Methods: The present study was conducted on 3776 babies born with risk factors for hypoglycemia in NICU. Screening for blood glucose level of study subjects were done at 2, 4, 6,12,24,48,78 hours of life, twice daily and whenever symptomatic by using glucometer. Babies were followed up till discharge. Incidence, risk factors and immediate outcome of hypoglycemia were assessed. Appropriate tests were applied.

Results: Incidence of hypoglycemia was 9.93% among high-risk neonates and overall incidence was 5.20%. 54.13% were males. 45% were preterm, 78.7% neonates were LBW. 53.07% were born to primiparous mother, 20.5% to diabetic mothers and 28.5% to hypertensive mothers. 16.8% had perinatal asphyxia, 14.66% new-born had underlying RDS. 48.5% were symptomatic, most common being lethargy 52.75% followed by jitteriness 43.41%, convulsion in 63 (34.62%). Preterm and LBW were significantly associated with mortality. Most common underlying comorbidities associated with deaths were sepsis (59.10%), RDS (45.46%), perinatal asphyxia (13.64%) and meconium aspiration syndrome (4.55%).

Conclusions: Neonates with one or more risk factors for hypoglycemia should be screened irrespective of symptoms within 72 hours of life. Focused counselling on early initiation of breast feeding will reduce the incidence of hypoglycemia and its complications.

 

References

Hosagasi NH, Aydin M, Zenciroglu A, Ustun N, Beken S. Incidence of hypoglycemia in new-borns at risk and an audit of the 2011 American academy of pediatrics guideline for hypoglycemia. Pediatr Neonatol. 2018;59:368-74.

Hay WW, Raju TNK, Higgins RD. Knowledge gaps and research needs for understanding and treating neonatal hypoglycemia: workshop report from Eunice Kennedy Shriver National Institute of Child Health and Human Development. J Pediatr. 2009;155:612-7

Kerstjens JM, Bocca-Tjeertes IF, de Winter AF, Reijneveld SA, Bos AF. Neonatal morbidities and developmental delay in moderately preterm- born children. Pediatrics. 2012;130:265-72.

Achoki R, Opiyo N, English M. Mini-review: management of hypoglycaemia in children aged 0–59 months. J Trop Pediatr. 2010;56:227-34.

Stomnarosk O, Petkovska E, Jancevska S, Danilovski D. Neonatal Hypoglycemia: Risk Factors And Outcomes. Contributions Sec Of Med Sci. 2017;23:31-8.

Bhand SA, Sheikh F, Siyal AR, Nizamani MA, Saeed M. Neonatal Hypoglycemia; Presenting pattern and risk factors of neonatal hypoglycemia. Professional Med J. 2014;21(4):745-9.

Kumar TJ, Vaideeswaran M, Seeralar AT. Incidence of hypoglycemia in newborns with risk factors. Int J Contemp Pediatr. 2018;5:1952-5.

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.

Hypoglycaemia in the newborn. Available at: https://www.who.int. Accessed on 20 February 2023.

Ishiguro A, Namai Y, Ito YM. Managing “healthy” late preterm infants. Pediatr Int. 2009;51(5):720-5.

Sabzehei MK, Basiri B, Bazmamoun H. The etiology, clinical type, and short outcome of seizures in newborns hospitalized in Besat Hospital/Hamadan/ Iran. Iran J Child Neurol. 2014;8(2):24-8.

Sheth RD, Hobbs GR, Mullett M. Neonatal sei-zure: Incidence, onset and etiology by gestation-al age. J Perinatol. 1999;19(1):40-3.

Burakevych N, McKinlay CJD, Harris DL. Factors influencing glycaemic stability after neonatal hypoglycaemia and relationship to neuro developmental outcome. Sci Rep. 2019;9:8132.

Shah R, harding J, Brown J, Mckinlay C. Neonatal Glycaemia and Neurodevelopmental Outcomes: A Systematic Review and Meta-Analysis. Neonatology. 2019;115:116-26.

Thirumalaikumarasamy S, Ramalingam E, Moorthi MM, Nadesan B. The incidence of asymptomatic hypoglycemia in term newborn babies weighing more than two kilograms. Int J Contemp Pediatr. 2017;4(4): 1267-73.

Babu MR, D’Souza JLP, 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):754-75.

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.

Tiple N, Kamble M, Chavan R, Naik S. Neonatal hypoglycemia in a tertiary care hospital. Int Med J. 2015;2(7):419-23.

Fluge G. Neurological findings at follow-up in neonatal hypoglycaemia. Acta Paediatr Scand. 1975; 64:629-34.

Singh M, Singhal PK, Paul VK. Neurodevelopmental outcome of asymptomatic & symptomatic infants with neonatal hypoglycaemia. Indian J Med Res. 1991;94:6-10.

Somanathan S, Pothapregada S, Varadhan A, Mathew RA. Clinical profile of hypoglycemia in neonates admitted in neonatal intensive care unit of a tertiary care hospital. Int J Contemp Pediatr. 2021;8:341-5.

Singh K, Kher AM. Clinicobiochemical profile of hypoglycemia in neonates admitted in NICU. Int J Contemp Pediatr. 2019;6:20-6.

Downloads

Published

2023-07-27

Issue

Section

Original Research Articles