Incidence of hypoglycemia in newborn infants identified as at risk

Stärk, Johanna; Simma, Burkhard; Blassnig-Ezeh, Anya

doi:10.1080/14767058.2019.1568985

Cited by 25 publications

(21 citation statements)

References 21 publications

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“…However, when the incidence of hypoglycemia was compared with each other it was concluded that hypoglycemia in exclusively breastfed high-risk newborns, did not have any sex predilection (p: 0.45). This observation was similar to the studies conducted by Saini A, et al [10] from Haryana, India in the year 2018, and a study conducted by Jonas D, et al [20] from Feldkirch, Austria the year 2014.…”

Section: Discussionsupporting

confidence: 91%

Hypoglycemia in Exclusively Breastfed High-Risk Neonates - A Hospital-Based Study

Patel¹,

R²,

Deb³

et al. 2020

Int J Pediatr Res

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Background: Hypoglycemia is one of the commonest metabolic problems in contemporary neonatal medicine. In the majority of healthy neonates, the frequently observed low blood glucose concentrations are not related to any significant problem and merely reflect normal processes of metabolic adaptation to extrauterine life. However, when low blood glucose levels are prolonged or recurrent, they may result in acute systemic effects and may result in neurologic sequelae. Aims and Objectives: To find out the incidence of hypoglycemia in exclusively breastfed high-risk newborns and to study associated risk factors like gender, gestational age, birth weight, time of onset of the development of hypoglycemia Methodology: This Descriptive Cross-sectional study of neonates enrolled 75 exclusively breastfed high-risk neonates (low birth weight, late preterms, small-for-gestation, large-for-gestation, infant of diabetic mother and macrosomic), who did not require admission to neonatal intensive care unit and were kept in postnatal wards with mother. Hypoglycemia was defined as blood glucose < 40 mg/dl. Blood glucose was monitored until 72 hours of life (at 2, 6, 12, 24, 48, 72 hrs of life). Results: The incidence of hypoglycemia in newborns with risk factors was 20% (15 of 75 neonates). All were asymptomatic. The incidence of hypoglycemia in SGA neonate was 37.5% (6/16), in LGA neonate was 18% (2/11), in Macrosomic neonates 20% (2/10), in LBW neonates 24% (9/38), in IDM was 14% (4/25) and in late preterm was 14% (2/12).In the present study, most of the neonates had hypoglycemia within 24 hours of life and none of the neonates were hypoglycemic after 48 hours of life. Conclusion: We conclude that the incidence of asymptomatic hypoglycemia is fairly common in high-risk neonates. Strict monitoring and a close watch are therefore necessary to detect hypoglycemia and institute measures to prevent progression to symptomatic hypoglycemia and sequelae later on in life.

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Section: Discussionsupporting

confidence: 91%

Hypoglycemia in Exclusively Breastfed High-Risk Neonates - A Hospital-Based Study

Patel¹,

R²,

Deb³

et al. 2020

Int J Pediatr Res

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“…The general incidence of hypoglycaemia in preterm infants exposed to antenatal steroids was 25%, with no significant differences between exposed with those unexposed. This incidence is within the ranges already reported in the literature and varies according to the reference values used, the additional risk factors of the newborn (being higher in those small for gestational age), and adherence to local guidelines [14,[25][26][27][28].…”

Section: Discussionsupporting

confidence: 82%

“…The time for the appearance of hypoglycaemia is variable; Stark et al report that 50% of hypoglycaemia in neonates with risks factors occurs between the first 2 hours and 20 minutes of life [25]. However, it would be necessary to analyse these data cautiously because it has been described that the physiological nadir in preterm and term neonates occurs in the first three hours of life [32].…”

Section: Discussionmentioning

confidence: 99%

Association between antenatal steroids for lung maturation and hypoglycaemia in the first 48 hours in premature infants between 26 and 34 weeks of gestational age

Valencia

Mendoza-Rojas

2019

pedm

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Introduction: Hypoglycaemia is frequent in premature infants and can generate neurological alterations. There is controversy concerning exposure to antenatal corticosteroids for pulmonary maturation and hypoglycaemia. Aim of the study: To evaluate whether there is a relationship between neonatal hypoglycaemia and the use of antenatal corticosteroids for lung maturation in preterm infants between 26 and 34 weeks of gestational age, and to correlate this with other variables. Material and methods: A prospective closed cohort study in preterm infants between 26 and 34 weeks of gestation, who were born in the University Hospital of Santander (HUS) between 2017 and 2018, divided into two cohorts: exposed and not exposed to antenatal corticosteroids for lung maturation. The data was analysed using Stata 12.0 Software. Results: Of 173 preterm infants, 152 (87.9%) received lung maturation. There were no significant differences between the maternal characteristics of both cohorts. In the neonatal group, sex, gestational age, birth weight, Apgar score, and glucose infusion rate were evaluated without significant differences. The cumulative incidence of hypoglycaemia in the first 48 hours was 28.6% in those not exposed to antenatal corticosteroids and 25.4% among the exposed ones (RR 0.875, IC95% 0.421-1.815), while the incidence density of hypoglycaemia was 8.80 and 6.36 events/1000 person-hours, respectively (HR 0.743 95% CI: 0.314-1.759). Conclusions: There was no significant difference in the incidence of hypoglycaemia among those exposed and those not exposed to antenatal steroids for lung maturation in this study.

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“…Although infants received an average of seven blood samples, the number of samples needed to detect one episode of hypoglycemia was 20. 54…”

Section: Risk Factors For Hypoglycemiamentioning

confidence: 99%

ABM Clinical Protocol #1: Guidelines for Glucose Monitoring and Treatment of Hypoglycemia in Term and Late Preterm Neonates, Revised 2021

Wight

Stehel²,

Noble³

et al. 2021

Breastfeeding Medicine

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A central goal of The Academy of Breastfeeding Medicine is the development of clinical protocols for managing common medical conditions that may impact breastfeeding success. These protocols serve only as guidelines for the care of breastfeeding mothers and infants and do not delineate an exclusive course of treatment or serve as standards of medical care. Variations in treatment may be appropriate according to the needs of an individual patient. PurposeT o provide guidance in the first hours/days of life to: Differentiate transitional neonatal hypoglycemia from persistent pathologic hypoglycemia Prevent clinically significant hypoglycemia in newborn infants Appropriately monitor blood/plasma glucose levels in at-risk term and late preterm neonates Manage clinically significant hypoglycemia in newborn infants to prevent neurologic injury Maximize breast milk provision to babies Establish and preserve maternal milk supply during medically necessary supplementation for hypoglycemia or during separation of mother and baby. About the 2020 Revised ProtocolKey research articles before 2014 were retained and more recent information was added from primary studies and compilations. Specific studies were assigned a level of evidence, and Strength of Recommendation Taxonomy (SORT: A, B, C) 1 was used for recommendations. The SORT rating system addresses the three key elements (quality, quantity, and consistency) recommended by the Agency for Healthcare Research and Quality. Levels of evidence are applied after each specific recommendation in brackets, e.g., [A], [B], [C].Recommendations are updated based on the last 6 years of new information and critical older studies. This clinical protocol is intended to provide practitioners with pragmatic evidence-based guidance to keep infants safe while mini-

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Incidence of hypoglycemia in newborn infants identified as at risk

Cited by 25 publications

References 21 publications

Hypoglycemia in Exclusively Breastfed High-Risk Neonates - A Hospital-Based Study

Hypoglycemia in Exclusively Breastfed High-Risk Neonates - A Hospital-Based Study

Association between antenatal steroids for lung maturation and hypoglycaemia in the first 48 hours in premature infants between 26 and 34 weeks of gestational age

ABM Clinical Protocol #1: Guidelines for Glucose Monitoring and Treatment of Hypoglycemia in Term and Late Preterm Neonates, Revised 2021

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