Hypoglycaemia: a Common Problem Among Uncomplicated Newborn Infants in Nepal

Anderson, Sarah R.; Shakya, Kiran; Shrestha, Laxman; Costello, A.

doi:10.1093/tropej/39.5.273

Cited by 54 publications

(36 citation statements)

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“…14 Anderson et al also observed a high incidence of hypoglycemia in babies who were unfed (or) were delayed breast feeding upto 24 hours. 20 None of the infants who had low plasma glucose levels showed any clinical signs of hypoglycemia. However, the glucose level in all increased immediately after feed.…”

Section: Discussionmentioning

confidence: 94%

The incidence of asymptomatic hypoglycemia in term newborn babies weighing more than two kilograms

Thirumalaikumarasamy

Ramalingam

Moorthi

et al. 2017

Int J Contemp Pediatr

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Background: Neonatal hypoglycemia is a common metabolic problem especially in cases like prematurity, sepsis and small gestational age. Episodes of asymptomatic hypoglycemia may occur due to many risk factors. The present study aimed to evaluate the incidence of asymptomatic hypoglycemia in term new born babies weighing more than 2 kg, to study the plasma sugar level at various time points during first 48 hours of life and to study the effect of maternal factors like parity, mode of delivery, glucose infusion during labour, and time since last feed on plasma sugar level.Methods: A hospital based longitudinal study was conducted over a period of one year from April 2005 to March 2006 in Kilpauk Medical College Hospital, Chennai. 400 babies born of consecutive deliveries were included in the study. Their plasma glucose levels were assessed in cord blood, 3 hr, 12 hr and 36 hr of life. Plasma glucose levels were analysed with regards to distribution, variables like parity, mode of delivery, dextrose infusion during labour and time since last feed. The plasma glucose levels were statistically analysed by paired student ‘t’ test, multiple analysis of variance (ANOVA), chi- square test using SPSS (version 7.5) statistical package.Results: The overall incidence of hypoglycemia was seen in 20% of the neonate’s in which 29.7% in small gestational age (SGA) and 16.7% in appropriate gestational age (AGA) babies. A significant (p <0.01) association between hypoglycemia and birth weight was observed. The association between hypoglycemia with parity, mode of delivery, sex of the baby and glucose infusion received by the mother was studied, but no significant association was found. A significant difference in plasma glucose based on birth weight at 3rd hour, 12th hour and 36th hour was observed (p <0.05). None of the infants showed any clinical signs of hypoglycemia.Conclusions: The incidence of hypoglycemia was noted in 20% of the neonates. Low birth weight was considered as risk factor. A significant association was also observed between plasma glucose, mode of delivery and time since last fed.

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Section: Discussionmentioning

confidence: 94%

The incidence of asymptomatic hypoglycemia in term newborn babies weighing more than two kilograms

Thirumalaikumarasamy

Ramalingam

Moorthi

et al. 2017

Int J Contemp Pediatr

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“…Therefore, dextrose gel may also be useful in resource-poor settings where hypoglycemia is common and under diagnosed. 8,9,29 We have shown that dextrose gel is an effective, well tolerated and acceptable treatment for neonatal hypoglycemia. Dextrose gel should be considered for first line management of late preterm and term hypoglycemic babies in the first 48 hours after birth.…”

Section: Discussionmentioning

confidence: 99%

Dextrose gel for neonatal hypoglycaemia (the Sugar Babies Study): a randomised, double-blind, placebo-controlled trial

et al. 2013

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BackgroundNeonatal hypoglycemia is common and a preventable cause of brain damage.Dextrose gel is used to reverse hypoglycemia in diabetics. However, there is little evidence for its use in babies. MethodWe enrolled 514 babies 35 to 42 weeks' gestation, < 48 hours, and at risk of hypoglycemia, to a randomized, double-blind placebo controlled trial to determine whether 40% dextrose gel massaged into the buccal mucosa is more effective than feeding alone in reversing hypoglycemia. Hypoglycemic babies were randomized to 40% dextrose gel 200 mg/kg (n= 118) or placebo (n= 119) and encouraged to feed.Primary outcome was treatment failure (blood glucose concentration <2·6 mmol/L) after two treatment attempts. FindingsDextrose gel reduced the frequency of treatment failure (16/118 (14%) in dextrose vs. 29/119 (24%) in placebo group, RR 0·57; 95% CI 0·33 to 0·98; p=0·04). Babies receiving dextrose gel were less likely to be admitted to intensive care for hypoglycemia, (16/118 (14%) vs. 30/119 (25%); RR 0.54 (0.31, 0.93); P=0.03), to receive formula feeds (median 7 vs. 10 feeds; median difference 2; 95% CI 0 to 4; p=0·04) and to be formula fed at two weeks (5/118 (4%) vs.15/119 (13%), RR 0·34; 95% CI 0·13 to 0·90; p=0·03). 3 InterpretationDextrose gel should be considered for first-line treatment for management of hypoglycemia in late preterm and term babies in the first 48 hours after birth.

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“…3,[8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25] Uniform adoption and application of the standard WHO definition is fundamental to coordinated advancements in detection and management, but hypothermia continues to be variably defined, leading to under-recognition and under-reporting, and inadvertent denial of care to those who are misclassified but in need of care.…”

Section: Definitionmentioning

confidence: 99%

“…The incidence of primary hypothermiaFan independent morbidity that presents as a result of cold stressFis high immediately following birth in hospital settings. [11][12][13][14]16,20,[58][59][60] Few studies have addressed aspects surrounding the birth and postpartum care that can put the newborn at risk for hypothermia. 9,16,57,61 In one village-based study in India, 11% of 189 neonates were found to be hypothermic (<35.6 1C) based on a single temperature reading taken within the first 24 h after birth.…”

Section: Pathophysiology Of Neonatal Hypothermiamentioning

confidence: 99%

Neonatal hypothermia in low resource settings: a review

et al. 2009

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Background: Hypothermia is increasingly recognized as a major cause of neonatal morbidity and mortality in resource poor settings. High prevalence of hypothermia has been reported widely from warmer high mortality regions of Africa and South Asia. The World Health Organization recognizes newborn thermal care as a critical and essential component of essential newborn care; however, hypothermia continues to remain under-documented, under-recognized and under-managed.Objective: This review aims to provide a thorough patho-physioepidemiological discussion of neonatal hypothermia applied to local risk factors within the developing country context with particular emphasis on prevention, recognition and management.Method: All available published literature on neonatal hypothermia relevant to resource poor settings were reviewed. Studies from the developing country settings were primarily reviewed for epidemiology, domiciliary risk factors as well as potential interventions for thermal care.Result and Discussion: Functional integrity and efficiency of biological systems is critically dependent on an optimal and very narrow range of core body temperature. Risk factors for neonatal hypothermia differ markedly within low resource settings. A combination of physiological, behavioral and environmental factors universally put all newborns, irrespective of birth weight, at risk of hypothermia. The knowledge deficit along the continuum from health providers to primary care givers has sustained the silent epidemic of hypothermia. The challenges of recognition, understanding of local risk factors and communication have meant a lack of informed thermal care for newborns. Simple, feasible interventions exist, but need to be applied, based on local risk factors that disrupt the warm chain. Further research is needed to document local risk factors, develop better techniques for recognition, evaluation of thermal care within essential newborn care and communication strategies for program effectiveness. Keywords: hypothermia; skin-to-skin care; warm chain; community; newborn; neonatal health Introduction 'If a definition of life were required, it must be most clearly on that capacity, by which the animal preserves its proper heat under the various degrees of temperature of the medium in which it livesy a few degrees of increase or diminution of the heat of the system, produces disease and death' said James Currie some two centuries ago, recognizing the central importance of temperature regulation in health. 1 Although folklore associated with increased temperature or fever has been recorded throughout history across virtually every culture and civilization, a recognition of hypothermia and its clinical significance, particularly for newborn health is a relatively recent advance. 1,2 Moreover, progress toward thermal care of newborns in developed countries has far outstripped knowledge and practice in developing country settings, where 99% of global neonatal deaths occur. 3,4 Hypothermia during the newborn period is widely regarded as a...

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Hypoglycaemia: a Common Problem Among Uncomplicated Newborn Infants in Nepal

Cited by 54 publications

References 0 publications

The incidence of asymptomatic hypoglycemia in term newborn babies weighing more than two kilograms

The incidence of asymptomatic hypoglycemia in term newborn babies weighing more than two kilograms

Dextrose gel for neonatal hypoglycaemia (the Sugar Babies Study): a randomised, double-blind, placebo-controlled trial

Neonatal hypothermia in low resource settings: a review

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