Incidence of hypoglycemia in newborns at risk and an audit of the 2011 American academy of pediatrics guideline for hypoglycemia

Hosagasi, Nihan Hilal; Aydın, Mustafa; Zencıroğlu, Ayşegül; Üstün, Nuran; Beken, Serdar

doi:10.1016/j.pedneo.2017.11.009

Cited by 45 publications

(28 citation statements)

References 21 publications

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“…Incidence of hypoglycemia in high risk neonates was 22.49 % at time of admission and incidence of two or more hypoglycemia episode in them was 5.29 %. The incidence of hypoglycemia in high risk neonates admitted to NICU as found in present study, was slightly similar to the incidence rates of the studies carried out by Hosagasi NH et al and Singh YP et al 7,8 Overall M: F ratio in current study was 1.15:1 which is similar to studies by Rasmussen et al and Saifuddin AA et al and slightly similar to studies by De AK et al,…”

Section: Discussionsupporting

confidence: 91%

Clinico-biochemical profile of hypoglycemia in neonates admitted in NICU

Singh¹,

Kher²

2018

Int J Contemp Pediatr

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Background: In high risk neonates’ incidence of hypoglycemia is up to 30%. There is limited evidence-based consensus regarding screening and management of neonates at risk of hypoglycemia. This study was undertaken to know the incidence, clinical profile, sequential blood glucose level upto 72 hours and short-term outcome of neonatal hypoglycemia.Methods: Blood sugar was screened at admission, after feed or D10 bolus, 6, 12, 24, 48 and 72 hours of age. Detailed maternal history and neonatal history, clinical manifestation, management and short-term outcome of hypoglycemic neonates were noted. Statistical analysis of data was done by SPSS 22.0 software.Results: 200 neonates with blood glucose less than 40mg/dl at admission to NICU in which 47 had repeat episode of hypoglycemia. Incidence of hypoglycemia at admission was 22.49% and 5.29% was incidence of repeat episode of hypoglycemia. Pre-term (p=0.005), low birth weight (p=0.020) and SGA (p=0.012) had repeat episode of hypoglycemia. GDM (p=0.040), birth asphyxia (p=0.046) and early septicaemia (p=0.0001) were common risk factors for hypoglycemia. Poor feeding, jitteriness and respiratory abnormality were common presentation of hypoglycemic neonates. The blood glucose levels at admission were less than 30 mg/dl in neonates who later had repeat episode of hypoglycemia. Most hypoglycemic episode after admission occurred within 24 hours of life.Conclusions: LBW especially Preterm SGA neonates are at increased risk of hypoglycemia. Maternal and neonatal risk factors are GDM and birth asphyxia, early septicaemia. Screening for hypoglycemia is essential for high-risk neonates.

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Section: Discussionsupporting

confidence: 91%

Clinico-biochemical profile of hypoglycemia in neonates admitted in NICU

Singh¹,

Kher²

2018

Int J Contemp Pediatr

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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%

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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“…En nuestro estudio se encontró que un Apgar a los 5 minutos en los recién nacidos a término muestra una asociación signi icativa con hipoglucemia; no obstante, como se mencionó en el estudio de cohorte de 2738 pacientes a término de Gilstrap y colaboradores, este puntaje por sí solo no de ine as ixia (patología asociada con el desarrollo de hipoglucemia) y no es satisfactorio para predecir el desenlace neurológico (15). Además, en el estudio de cohorte de 207 pacientes de Hosagasi y colaboradores no se encontró asociación alguna con el Apgar evaluado a los 5 minutos y su efecto en la incidenhttp://revistaendocrino.org/ (16); lo que contrasta con lo encontrado en nuestros pacientes. Hay que tener en cuenta que la edad gestacional, medicamentos de uso materno, el tipo de anestésico administrado durante la cesárea y la persona que asignó el puntaje pueden in luir en la puntuación.…”

Section: Discussionunclassified

“…En nuestro estudio no se pudo determinar el impacto de este factor dado que ningún control recibió fórmula y tampoco se realizó regresión logística incorporando las variables que aportaron el desenlace en el anterior. Sin embargo, en el estudio de Hosagasi y colaboradores (16) no se encontró dicha asociación con una muestra mayor, lo que evidencia una dicotomía en la literatura médica.…”

Section: Discussionunclassified

Factores de riesgo para hipoglucemia neonatal transitoria en pacientes a término, estudio de casos y controles en un hospital de Bogotá

Colmenares

Camacho

Ortiz

et al. 2021

Rev.ACE

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Introducción: la hipoglucemia neonatal es frecuente y puede presentarse de forma transitoria o persistente. Existen diferentes puntos de corte de glucemia para poder definirla y usualmente son menores de 47 mg/dL. Se han evidenciado factores de riesgo tanto maternos como neonatales para desarrollar esta enfermedad, que aumentan el riesgo de padecerla entre un 14,7 % y 83,2 % en comparación a un 5% respecto a los pacientes que no los poseen. Así mismo se ha demostrado que el retraso en el tratamiento de la hipoglucemia genera alteraciones en el neurodesarrollo. Objetivo: determinar los factores de riesgo asociados con hipoglucemia neonatal transitoria de recién nacidos a término sin factores de riesgo determinados por la guía de la Academia Americana de Pediatría, en el Hospital Universitario Clínica San Rafael en el período comprendido de enero de 2015 a enero de 2019. Metodología: estudio observacional analítico, retrospectivo de tipo casos y controles, desde enero de 2015 a enero de 2019. Se realiza el cálculo de muestra y se obtienen 35 casos y 35 controles mediante el software estadístico Real Statistics 6.9 de enero de 2020. Resultados: La mayor proporción de pacientes en el estudio fue de sexo femenino (61,43 %), 20 casos y 23 controles. El promedio de glucosa de ingreso de los casos fue de 40,8 mg/dL. Dentro de los factores de riesgo se encontró el sobrepeso materno (OR de 1,2), cesáreas (OR 2,5), hipertensión inducida por el embarazo (OR 4,38). Se encontró una asociación significativa con Apgar al minuto de 5 (3 pacientes [8,57 %]); primer aporte energético recibido del recién nacido (25 [71,4 %] recibieron lactancia materna), taquipnea transitoria del recién nacido (6 [17,14 %]) y policitemia (10 [28,57 %]) como variables en el recién nacido y el tiempo de apego como variable materna (7 [20 %]) en los casos que no la recibieron. Conclusiones: en la población a término considerada sana que desarrolla hipoglucemia neonatal transitoria se encontró asociación con un Apgar al minuto de 5, el primer aporte energético recibido, la taquipnea transitoria del recién nacido, la policitemia y el apego como factores que influyen en su aparición. Se hace un llamado para hacer una mayor vigilancia de este grupo de recién nacidos que, aunque presentan menor incidencia de hipoglucemia, sí necesitan del acompañamiento y seguimiento.

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Incidence of hypoglycemia in newborns at risk and an audit of the 2011 American academy of pediatrics guideline for hypoglycemia

Abstract: Highest risk for hypoglycemia in early postnatal period was present especially in LPI group. Our compliance levels with the AAP guideline was found to be satisfactory.

Cited by 45 publications

References 21 publications

Clinico-biochemical profile of hypoglycemia in neonates admitted in NICU

Clinico-biochemical profile of hypoglycemia in neonates admitted in NICU

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

Factores de riesgo para hipoglucemia neonatal transitoria en pacientes a término, estudio de casos y controles en un hospital de Bogotá

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