Study of incidence, clinical profile and risk factors of neonatal hypoglycemia in a tertiary care hospital

Abstract

Background: The reported incidence of hypoglycemia varies with its definition. The clinical manifestations of hypoglycemia are nonspecific and similar to those of many disorders in newborn infants. Persistent hypoglycemia is more likely to be associated with possible neurologic sequelae. However, its definition, clinical significance, and management remain controversial. Methods: This prospective observational study was done over a period of 2 years. Babies admitted to Neonatal intensive care unit with whole blood sugar levels <40 mg/dl and fulfilling inclusion criteria were taken up for the study. These babies were subjected to detailed history taking, thorough clinical examination and investigations. The babies were observed for signs and symptoms of hypoglycemia. Results: Neonatal hypoglycemia constituted about 8.26%. Majority of hypoglycemic babies were preterm babies. Asymptomatic hypoglycemia was predominantly noticed in preterm babies (65.21%). Term babies (58.82%) showed more symptoms with hypoglycemia than preterm babies. The major clinical manifestations are jitteriness, lethargy, convulsions and apneic spells. PIH and prematurity are most associated risk factors. Significantly low Sugar levels (p value <0.005) were noticed in symptomatic hypoglycemic babies. Conclusion: Hypoglycemia in neonates can have variable presentations indicating the need for detailed and thorough examination for evidence of hypoglycemia. Identification of risk factors of hypoglycemia and proper monitoring blood glucose levels should be done to plan early treatment and prevent neurological damage.

Clinico-biochemical profile of hypoglycemia in neonates admitted in NICU

“…GDM was also a common maternal risk factor in studies done by Manjunatha BR et al, Singh YP et al and Bhand SA et al which is similar to the current study. 8,12,15 Pre-eclampsia was also present in Amarendra M, Manjunatha BR et al, Singh YP et al and Bhand SA et al which is similar to the current study. 16,12,15,8 PROM as maternal risk factor was only present in Amarendra M et al study which is similar to current study.…”

“…In current study birth asphyxia was more common neonatal risk factor than early septicaemia and RDS which was similar to study done by Dhananjaya CP et al, Burden et al and Manjunatha BR et al 11,14,12 Early septicemia was more common in the study done by Indira P et al and Stomnaroska et al and RDS was more common in the study by Bhand SA et al so that these are not similar to current study. 13,17,16 Most common symptoms of hypoglycemia were poor feeding, lethargy, jitteriness, seizure and respiratory abnormality which was similar to study done by Dhananjaya 11,13,16,18,12,8,10,15 In the current study, blood glucose level below 30 mg/dl was more commonly seen in neonates having more than one episode of hypoglycemia. The blood glucose levels at admission were in lower range in neonates who later had repeat episode of hypoglycemia.…”

“…Dhananjaya CP et al, Manjunatha BR et al and Singh YP et al 9,10,5,11,12,8 The ratio of pre-term, term and post-term neonates at risk of hypoglycemia in the current study was similar to those found in the studies by Manjunatha et al, Indira et al, Burdan et al and Bhand et al [12][13][14][15] The ratio of pre-term, term and post-term neonates did not match with studies by Singh YP et al and De AK et al in which pre-term neonates are less whereas in study by Dhananjaya CP et al post-term neonates were 10.5%. 8,5,11 In the current study, we found that higher chances of hypoglycemia episode were present in low birth weight babies and similar to studies done by De AK et al and Indira P et al 5,13 AGA babies had more chances of hypoglycemia in current study could be because of more number of AGA babies admitted in NICU during study period which is similar to study done by Singh YP et al 8 In current study most, neonates with hypoglycemia had maternal risk factors such pre-eclampsia, GDM and PROM for neonatal hypoglycemia.…”

Study of incidence, risk factors and immediate outcome of hypoglycemia in neonates admitted in NICU

“…13 Babu et al showed that 57.5% were term and 42.5% were preterm. 16 Gestational age: In present study, 169 (45.06%) were SGA, 145 (38.67%) were AGA and 61(16.27%) were…”

“…In study by Dhananjaya et al showed that SGA-14.75%, LGA-22.22%. 8,16 Bhand et al showed that 26% were small for gestational age. 6 Stomnarosk et al showed that mean gestational age was 33.05±3.19 weeks.…”