DOI: http://dx.doi.org/10.18203/2349-3291.ijcp20172515

The incidence of asymptomatic hypoglycemia in term newborn babies weighing more than two kilograms

Sivaraman Thirumalaikumarasamy, Ezhilarasu Ramalingam, Mani Madhavan Sachithanantha Moorthi, Balakrishnan Nadesan

Abstract


Background: Neonatal hypoglycemia is a common metabolic problem especially in cases like prematurity, sepsis and small gestational age. Episodes of asymptomatic hypoglycemia may occur due to many risk factors. The present study aimed to evaluate the incidence of asymptomatic hypoglycemia in term new born babies weighing more than 2 kg, to study the plasma sugar level at various time points during first 48 hours of life and to study the effect of maternal factors like parity, mode of delivery, glucose infusion during labour, and time since last feed on plasma sugar level.

Methods: A hospital based longitudinal study was conducted over a period of one year from April 2005 to March 2006 in Kilpauk Medical College Hospital, Chennai. 400 babies born of consecutive deliveries were included in the study. Their plasma glucose levels were assessed in cord blood, 3 hr, 12 hr and 36 hr of life. Plasma glucose levels were analysed with regards to distribution, variables like parity, mode of delivery, dextrose infusion during labour and time since last feed. The plasma glucose levels were statistically analysed by paired student ‘t’ test, multiple analysis of variance (ANOVA), chi- square test using SPSS (version 7.5) statistical package.

Results: The overall incidence of hypoglycemia was seen in 20% of the neonate’s in which 29.7% in small gestational age (SGA) and 16.7% in appropriate gestational age (AGA) babies. A significant (p <0.01) association between hypoglycemia and birth weight was observed. The association between hypoglycemia with parity, mode of delivery, sex of the baby and glucose infusion received by the mother was studied, but no significant association was found. A significant difference in plasma glucose based on birth weight at 3rd hour, 12th hour and 36th hour was observed (p <0.05). None of the infants showed any clinical signs of hypoglycemia.

Conclusions: The incidence of hypoglycemia was noted in 20% of the neonates. Low birth weight was considered as risk factor. A significant association was also observed between plasma glucose, mode of delivery and time since last fed. 


Keywords


Birth weight, Maternal factors, Neonatal hypoglycemia, Plasma glucose level

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References


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.

Stanley CA, Baker L. The causes of neonatal hypoglycemia. (Editorial) N Engl J Med. 1999;340(15):1200-1.

Hoseth E, Joergensen A, Ebbesen F, Moeller M. Blood glucose level in a population of healthy breastfed term infants of appropriate size for gestationalage. Arch Dis child Fetal Neonatal Ed. 2000;83:227-9.

Hawdon JM, Ward Platt MP. Metabolic adaptation in small for gestational age infants. Arch Dischild 1993;68:262-8.

Williams AF. Hypoglycemia of the newborn. Rev Bull World Health organization. 1997;75:261-90.

Duvanel CB, Fawer CL. Long term effect of neonatal hypoglycemia on brain growth and psychomotor development in small for gestational age infants. J Paediatrics. 1999;134:492-8.

Lucas A, Morley R, Cole TJ. Adverse neurodevelopmental outcome of moderate ultimated hypoglycemia. BMJ. 1988;297:1304-8.

Behrman RE, Nelson KR. Textbook of Paediatrics. 16th Edn. 2000: 533-534.

Sexson WR. Incidence of neonatal hypoglycemia: A matter of definition. J Pediatr. 1984;105:149–50.

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

Alkalay Arie L. Brain Imaging Findings in Neonatal Hypoglycemia: Case Report and Review of 23 Cases. Clinics of Pediatrics (Phila). 2005;44(9):783-90.

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):7-10.

Sasidharan CK, Gokul E, Sabitha S. Incidence and risk factors for neonatal hypoglycemia in Kerala, India. Ceylon Med J. 2004;49(4):110-3.

Diwakar KK, Sasidhar MV, Plasma glucose level in term infants who are appropriate size for gestation and exclusively breastfed. Arch Dis. Child FetalNeonatal Ed. 2002;87:46-8.

Erenburg H. Serum glucose level in breastfed and bottle fed infants during 48 hours of life. Arch Dis child. 1992;64:1486-8.

Narang A, Bhat MA, Kumar P. Hypoglycemia in small for gestational age babies. Ind J Paediatr. 2001;68 (10):963-5.

Scholl TO, Chen X, San Khoo C, Lenders C. The dietary glycemic index during pregnancy: influence on infant birth weight, fetal growth, and biomarkers of carbohydrate metabolism. Am J Epidemiol. 2004;159(5):467-74.

Weissman A, Solt I, Zloczower M, Jakobi P. Hypoglycemia during the 100-g oral glucose tolerance test: incidence and perinatal significance. Obstet Gynecol. 2005;105(6):1424-8.

Srinivasan G, Pildes RS, Cattamanchi G, Vooras, Lillen Lb. Plasma glucose values in term neonates: A new look. J Pediatrics. 1986; 109114-7.

Anderson S, Shakya KN, Shrestha LN, Costello AM. Hypoglycaemia: a common problem among uncomplicated newborn infants in Nepal. J Trop Pediatr. 1993;39(5):273-7.