AIMS: 1. To know the various risk factors of neonatal hypoglycemia and their incidence among the babies admitted in tertiary care hospital, ASRAM, Eluru. 2. To know the outcome of neonatal hypoglycemia in both symptomatic and asymptomatic newborns in tertiary care hospital, ASRAM, Eluru. DESIGN: Prospective study. SETTING: Tertiary hospital based study over 24 months.
METHODS:Blood glucose values are measured using Reagent Strip method (Glucotrend2 of USA. and confirmed by Laboratory Diagnosis The blood glucose values were measured at 1, 2, 4, 6, 12, 24, 36, 48 and 72 hours of life or till discharge whichever is earlier. RESULTS: A total of 150 cases where observed of which 59 cases (33.3%) developed hypoglycemia. The common risk factors observed are low birth weight in 23(46%), sepsis in 12(24%), IDM in 5 (10%), asphyxia in 4(8%) and 6 cases (12%) have no risk factors. 76.9% of the cases have developed hypoglycemia at the first hour of life. In our study 52% of neonates with hypoglycemia have recovered well with oral feeds given at 30mins.The remaining 48% required glucose infusion. Only 1 case had recurrent hypoglycemia (2%) even on glucose infusion and it is controlled with single dose hydrocortisone. CONCLUSIONS: Hypoglycemia is a common in the newborns, and a high index of suspicion is required to identify it early. It is also an easily treatable problem, in most occasions. Hypoglycemia in the newborn if detected and treated early will prevent adverse neurodevelopmental outcome. KEYWORDS: hypoglycemia, low birth weight, risk factors, neurodevelopment.
INTRODUCTION:Hypoglycemia is a common disorder in neonates. 1, 2 In neonates there is not always an obvious correlation between blood glucose concentration and the classic clinical manifestation of hypoglycemia. The absence of symptoms does not indicate that glucose concentration is normal. There is still no universal definition for this disorder. 3 The definition of clinically significant hypoglycemia is one of the most confused and contentious issue in contemporary. Koh et al did a detailed survey and found that the definition ranged from 18 mg/dl to 72mg/dl. Confusion exists due to the fact that the "normal" range of blood glucose is different for each newborn and depends upon a number of factors including birth-weight, gestational age, body stores, feeding status, availability of energy sources as well as the presence or absence of disease. Thus the definition of hypoglycemia should be flexible and encompass all these aspects. Further, there is no concrete evidence to show the causation of adverse long-term outcomes by a particular level or duration of hypoglycemia. 4 A recent consensus has been to evolve an "operational threshold". This threshold is currently believed to be a blood glucose value of less than 40 mg/dl (plasma glucose less than 45 mg/dl). Many