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

Abstract

Introduction: Hypoglycemia is a frequent metabolic problemin the nursery and neonatal intensive care unit.1 The majority ofincidents of neonatal hypoglycemia are transient and representtypical glucose metabolism. Also, hypoglycemia signs maymatch those of various newborn illnesses. The aim of the studywas to evaluate the clinical profile and risk factors of neonatalhypoglycemia in neonatal admitted to a tertiary care teachinghospital.Materials and Methods: It was a prospective hospital-basedstudy conducted in the Pediatric unit of Shri Ram Murti SmarakInstitute of Medical Sciences, Bareilly, which is a tertiary careteaching hospital of the Rohilkhand region. All neonates wereadmitted to the Pediatric Department and bedside glucoselevels <40 mg/dl were included. Initial blood glucose levelswere checked by glucometer in all neonates within 2 hoursof admission and once daily thereafter. Repeat testing wasdone whenever it was clinically indicated (lethargy, refusal tofeed or new onset seizures) and in neonates with documentedhypoglycemia at 2nd, 6th, 12th, 24th, 48th and 72nd hours of initialepisode and management.Results: The development of hypoglycemia was seen in babiesborn to mothers who had diabetes mellitus or gestationaldiabetes 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 ofmaternal risk factors. The prevalence of SGA (49.48%) was thefactor 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 whohad the clinical presentation of hypoglycemia. Cyanosis wasnot observed in any neonate with hypoglycemia.Conclusion: Hypoglycemia is the most preventable metaboliccondition in neonates. The result showed that LBW, SGA,LGA, IDM/IGDM, newborns with respiratory distress, sepsis,hypothermia, and neonates with delayed and infrequent feedinghad an increased risk of hypoglycemia. The most commonpresentation was lethargy, jitteriness and seizures amongthese neonates.