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

Abstract

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.

A cross-sectional study on the frequency and risk factors for neonatal hypoglycemia in babies born in rural Kerala

“…In our study, 50% of LGA babies had at least one value of low blood sugars. In the study by Patel et al ,[ 22 ] the incidence of hypoglycemia in SGA neonate was 37.5%, in LGA neonate was 18%, in macrosomic neonates was 20%, in LBW neonates 24%, in infant of diabetic mother was 14% and in late pre-term was 14%. In the study by Ute et al ,[ 23 ] routine glucose testing was indicated in LGA newborn infants of nondiabetic mothers.…”

Berat badan lahir dan kejadian hipoglikemia pada neonatus

“…Studi Patel P et al menemukan 20% bayi makrosomia dan 18% bayi dengan berat lahir lebih besar dari usia gestasi mengalami hipoglikemia pada 24 jam pertama dan normal kembali saat 48 jam berikutnya. (22) Kayode-Adedeji B yang meneliti 290 bayi makrosomia mendapatkan bahwa hipoglikemia dan ikterik merupakan masalah yang sering muncul dan biasanya berkaitan dengan diabetes gestational pada ibu. (23) Hasil analisis bivariat pada penelitian ini menunjukkan adanya hubungan antara berat badan lahir bayi dan kejadian hipoglikemia.…”