Abstract
Large for gestational age (LGA) accounts for about 6.3% of admissions in kenyatta national hospital, newborn unit. As a policy all IGA's, defined by birth weight of 4000 g and above are admitted for 24 hours to monitor blood glucose levels. The rational for this policy is questionable and contributes to unnecessary burden on resources needed for new born care. To study birth weight related incidence of hypoglycemia and hypocalcaemia in stable low risk lgas in knh and use it to establish a new admission weight based criteria. prospective cohort study done in new born-unit, post natal and labour wards of knh. Term lga neonates (birth weight = 4000 g) were recruited as subjects and controlled against term appropriate weight (aga) neonates. the incidence of hypoglycemia and hypocalcaemia in lgas was 21% and 9% respectively. Hypoglycemia was rarely encountered after 12 hours of life in lgas. Hypoglycemia and hypocalcaemia showed a direct upward relationship with weight beyond 4250 g. No significant difference in incidence of hypoglycemia and hypocalcaemia between controls and 4000-4249 g category to justify their routine admission to newborn unit. the study identified 4275 g as new admission birth weight criteria for stable term low risk IGA's admission.
Highlights
Large for gestational age (LGA) accounts for about 6.3% of admissions in kenyatta national hospital, newborn unit
A large for gestational age neonate is defined as neonate whose birth weight has exceeded the expected for the gestation of pregnancy represented as birth
This study aims to determine birth weight related incidence of hypoglycemia and hypocalcaemia in stable low risk LGAs and use it to determine a new weight based admission criteria
Summary
Large for gestational age (LGA) accounts for about 6.3% of admissions in kenyatta national hospital, newborn unit. As a policy all IGA’s, defined by birth weight of 4000g and above are admitted for 24hours to monitor blood glucose levels. The rational for this policy is questionable and contributes to unnecessary burden on resources needed for new born care. Objective: To study birth weight related incidence of hypoglycemia and hypocalcaemia in stable low risk lgas in knh and use it to establish a new admission weight based criteria. No significant difference in incidence of hypoglycemia and hypocalcaemia between controls and 4000-4249g category to justify their routine admission to newborn unit. Other contributory factors include: maternal birth weight and stature,(15) immunological disorders like rhesus isoimmunization, advanced maternal age and idiopathic polyhydramnios
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