Prospective observational study to determine the clinical profile of hypoglycemia in newborn and to determine the prevalence of hypoglycemia among neonates admitted in NICU
European Journal of Molecular & Clinical Medicine,
2020, Volume 7, Issue 7, Pages 4816-4821
AbstractAim: to determine the clinical profile of hypoglycemia in newborn and to determine the prevalence of hypoglycemia among neonates admitted in NICU.
Material and methods: This prospective observational study was done the Upgraded Department of Paediatrics, Patna Medical College & Hospital, Patna, Bihar, India, for July 2017 to July 2018 . 120 Patients admitted in NICU with blood glucose less than 45 mg/dl were included in this study. In neonates with risk factors blood sugar was screened at 2, 6, 12, 24, 48 and 72 hours of life or whenever symptoms suggestive of hypoglycemia developed in any neonates and for critically sick neonates blood sugar was screened in every 6 hour in active phase of illness.
Results: The total number of admissions in NICU during the study period was 720 and among them the prevalence of hypoglycemia was 120 (16.67%). Among the 120 neonates with hypoglycemia, 70 (58.33%) were males and 50 (41.67%) were females. Among the study population 104 (86.67%) of neonates had at least one risk factor (maternal/neonatal) and 16 cases (13.33%) had no risk factor. The maternal risk factors that were associated with hypoglycemia were GDM, PIH, PROM. 19.17% had GDM, 11.67% had PIH and 2.5% had PROM as maternal risk factors. 66.67% had no maternal risk factor. The neonatal risk factors associated with hypoglycemia were prematurity 33(27.5%), SGA 38(31.67%), LGA 8(6.67%), IDM 26(21.67%) and comorbidities (sepsis, birth asphyxia, polycythemia and shock) were present in 21(17.5%) of the hypoglycemic neonates. Among the comorbid condition birth asphyxia was present in 8 (6.67%), sepsis in 9(7.5%), polycythemia in 3(2.5%) and shock in 1 (0.83%). 86.67% of the hypoglycemic neonates had at least one risk factor. Out of 120 children with hypoglycemia 78 (65%) were asymptomatic and 42 (35%) presented with symptoms. The common symptoms were poor feeding (66.67%), lethargy (19.05%), jitteriness (4.17%), irritability (2.5%), hypotonia (0.83%) and cyanosis (0.83%). 31.67% of neonates presented with hypoglycemia on day 1 of life, 25% of neonates on day 2, 20.83% on day 3 and 22.5% beyond 72 hours of life.
Conclusion: Blood glucose screening in neonates with this risk factor is mandatory as many of the neonates were asymptomatic. The importance of early initiation of breast feeding to prevent hypoglycemia should be emphasized.
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