Clinical Profile and Risk Factors of Neonatal Hypoglycemia in Tertiary Care Teaching Hospital

Abstract

Introduction: Hypoglycemia is a frequent metabolic problem
in the nursery and neonatal intensive care unit.1 The majority of
incidents of neonatal hypoglycemia are transient and represent
typical glucose metabolism. Also, hypoglycemia signs may
match those of various newborn illnesses. The aim of the study
was to evaluate the clinical profile and risk factors of neonatal
hypoglycemia in neonatal admitted to a tertiary care teaching
hospital.
Materials and Methods: It was a prospective hospital-based
study conducted in the Pediatric unit of Shri Ram Murti Smarak
Institute of Medical Sciences, Bareilly, which is a tertiary care
teaching hospital of the Rohilkhand region. All neonates were
admitted to the Pediatric Department and bedside glucose
levels <40 mg/dl were included. Initial blood glucose levels
were checked by glucometer in all neonates within 2 hours
of admission and once daily thereafter. Repeat testing was
done whenever it was clinically indicated (lethargy, refusal to
feed or new onset seizures) and in neonates with documented
hypoglycemia at 2nd, 6th, 12th, 24th, 48th and 72nd hours of initial
episode and management.
Results: The development of hypoglycemia was seen in babies
born to mothers who had diabetes mellitus or gestational
diabetes at a rate of 42.27%, eclampsia at a rate of 10.31%,
and mode of delivery at a rate of 21.65% in the category of
maternal risk factors. The prevalence of SGA (49.48%) was the
factor that was related with hypoglycemia the most frequently.
Lethargy (49.49%), jitteriness (47.42%), and seizures (42.27%)
were the most prevalent manifestations found in infants who
had the clinical presentation of hypoglycemia. Cyanosis was
not observed in any neonate with hypoglycemia.
Conclusion: Hypoglycemia is the most preventable metabolic
condition in neonates. The result showed that LBW, SGA,
LGA, IDM/IGDM, newborns with respiratory distress, sepsis,
hypothermia, and neonates with delayed and infrequent feeding
had an increased risk of hypoglycemia. The most common
presentation was lethargy, jitteriness and seizures among
these neonates.