Introduction: Hypoglycemia is a common problem in neonatal period associated with adverse neurological outcome and brain injury if treatment was not provided. AAP and PES recommended screening for hypoglycemia only in newborns with risk factors but many others neonates may present episodes of asymptomatic hypoglycemia without any known risk factor.
Objectives: To assess the incidence of hypoglycemia in healthy full term neonates without any risk factors in our medical center and to correlate it with mothers BMI, the initiating time of feeding and the difference between breast feeding and formula. To prove the benefit of universal neonatal screening of hypoglycemia in saving many full term newborns without any risk factors.
Materials and methods: A hospital based, prospective longitudinal study involving 300 healthy full term asymptomatic neonates. Blood glucose level was measured at 60 and 90 min of life using reagent strips and Glucometer independent of feeding time.
Results: According to the definition of hypoglycemia by the AAP (glycemia < 40 mg/dl) and PES (glycemia <50 mg/dl), the overall incidence of hypoglycemia in asymptomatic healthy full term newborns was 12.1% and 30.9% at 60 min respectively, while it was 1.1% and 17% at 90 min respectively. There was no significant statistical association between BMI of the mother and hypoglycemia in neonates. However, the frequency of hypoglycemic episode in babies born at 37 weeks of gestation was higher than those born at 38 weeks and above with a significant P value of 0.0001. Neonates who were breastfed presented much less hypoglycemia than formula fed neonates with statistically significant P value of 0.0001. There was a higher incidence rate of hypoglycemia when feeding was initiated above 1 hour after delivery.
Conclusion: Delayed initiation of feeding, gestational age below 38 weeks and bottle fed infants were significantly associated with hypoglycemia. It is preferable to do a universal glycemic screening for all newborns to prevent transient neonatal hypoglycemia, which could have some deleterious consequences on the central nervous system and to start breastfeeding within 1 hour after delivery.
Keywords: Hypoglycemia, neonates, breastfeeding.
27 - 29 Sep 2018
European Society for Paediatric Endocrinology