Prevalence and factors associated with neonatal hypoglycemia in Northern Uganda: a community-based cross-sectional study

Abstract

Background Neonatal hypoglycemia is the most common endocrine abnormality in children, which is associated with increased morbidity and mortality. The burden and risk factors of neonatal hypoglycemia in rural communities in sub-Saharan Africa are unknown. Objective To determine the prevalence and risk factors for neonatal hypoglycemia in Lira District, Northern Uganda. Methods This was a community-based cross-sectional study, nested in a cluster randomized controlled trial designed to promote health facility births and newborn care practices in Lira District, Northern Uganda. This study recruited neonates born to mothers in the parent study. Random blood glucose was measured using an On Call® Plus glucometer (ACON Laboratories, Inc., 10125 Mesa Road, San Diego, CA, USA). We defined hypoglycemia as a blood glucose of < 47 mg/dl. To determine the factors associated with neonatal hypoglycemia, a multivariable linear regression mixed-effects model was used. Results We examined 1416 participants of mean age 3.1 days (standard deviation (SD) 2.1) and mean weight of 3.2 kg (SD 0.5). The mean neonatal blood glucose level was 81.6 mg/dl (SD 16.8). The prevalence of a blood glucose concentration of < 47 mg/dl was 2.2% (31/1416): 95% CI 1.2%, 3.9%. The risk factors for neonatal hypoglycemia were delayed breastfeeding initiation [adjusted mean difference, − 2.6; 95% CI, − 4.4, − 0.79] and child age of 3 days or less [adjusted mean, − 12.2; 95% CI, − 14.0, − 10.4]. Conclusion The incidence of neonatal hypoglycemia was low in this community and was predicted by delay in initiating breastfeeding and a child age of 3 days or less. We therefore suggest targeted screening and management of neonatal hypoglycemia among neonates before 3 days of age and those who are delayed in the onset of breastfeeding.

Determinants of neonatal hypoglycemia among neonates admitted at Hiwot Fana Comprehensive Specialized University Hospital, Eastern Ethiopia: A retrospective cross-sectional study

“…In comparison to studies done in Uganda (2.2%), 18 India (9.4%), 25 Iraq (16.25%), 26 Côte d’Ivoire (15.9%), 27 and Nigeria (11.0%), 28 our study’s overall magnitude of neonatal hypoglycemia is greater. In our investigation, a cross-sectional study was undertaken, whereas a community-based cross-sectional study was carried out in Uganda 18 which may be a reason for this disparity. The method used to measure newborns’ blood glucose concentrations varied, which might have made the differences in finding.…”

“…This corresponds to finding from Uganda. 18 The importance of encouraging moms to breastfeed their newborns during the first hour of birth is reinforced by this finding. Additionally, it clarifies a possible mechanism through which postponed breastfeeding can raise the risk of newborn morbidity and death.…”

“…After reviewing relevant literature, a semi-structured data extraction tool 2 , 10 , 17 , 18 was developed to obtain information on sociodemographic characteristics of mothers and neonates, antepartum-related factors, neonatal and intrapartum-related factors, and the treatment given to newborn through chart review. Four BSc nurses gathered the data under the supervision of 1 MSc nurse.…”

Impacts of Hypoglycemia in At-Risk Infants on Admissions to Level-3 Neonatal Units in a Tertiary-Care Hospital

“…[15][16][17] In one prospective study, the incidence of blood sugar ≤2.0 mmol/L was 19%, and was mostly observed in the first 24 h. 18 In another prospective study involving healthy newborns, blood glucose <2.6 mmol/L was more frequent in those who had a delayed initiation of breastfeeding, with an overall incident of 2.2% in the first three days. 19 In a retrospective study, the nadir of plasma glucose in late-preterm infants was similar to that in term infants (mean, ~90 min). 20…”

Maximizing the detection rate of hypoglycemia among preterm neonates admitted in Neonatal intensive care unit in Ethiopia, 2021

“…Thus, recognizing and treating the above associated factors is essential to preventing, and controlling hypoglycemia.Neonatal hypoglycemia is characterized by a lower-than-normal blood glucose level 1 , which is a plasma glucose level of less than 30 mg/dL in the first 24 h of birth and less than 45 mg/dL in the last 24 h of life 2 . Prematurity, small for gestational age, prenatal hypoxia, and neonates delivered to diabetic moms are all at risk for neonatal hypoglycemia 3,4 .Preterm neonates are particularly susceptible to developing hypoglycemia and its associated complications because of their low glycogen and fat reserves, inability to produce new glucose through gluconeogenesis pathways, higher metabolic demands brought on by their relatively larger brains, and inability to mount a counterregulatory response to hypoglycemia 5,6 .…”