Should routine peripheral blood glucose testing be done for all newborns at birth?
OBJECTIVE
To determine the (1) incidence of peripheral blood glucose (PBG < 40 mg/dL) in infants within 2 hours of birth and (2) validity of using maternal and infant risk factors and/or infant signs/symptoms of hypoglycemia as a screen for PBG < 40 mg/dL.


METHODS
Descriptive study with a convenience sample of 220 mother-infant dyads admitted to a mother-baby unit. Maternal and infant risk factors and infant signs/symptoms of hypoglycemia were assessed, and a PBG value was obtained within 2 hours of birth from the infant. Data were analyzed with descriptive statistics, multiple regression analysis, and sensitivity and specificity testing.


RESULTS
The incidence of PBG < 40 mg/dL was 5.1% (N = 10 of 198). Fifteen maternal/infant risk factors were found; 2 of the 23 risk factors predicted PBG values within 2 hours of birth at a statistically significant level (jitteriness [p = .011] and tachypnea [p = .033]). Sensitivity was 71.9% and specificity 44.7% for using the presence of at least one maternal/infant risk factor and/or infant signs/symptoms of hypoglycemia to correctly identify PBG < 40 mg/dL within 2 hours of birth.


CONCLUSIONS
Nurses working with mothers and infants can use the data from our study along with the recommendations from professional organizations such as American Academy of Pediatrics to begin a conversation at their institutions about revising protocols for routine PBG testing. Screening infants for maternal/infant risk factors and infant signs/symptoms of hypoglycemia could be used instead to safely decrease by 45% the number of infants who would need to have a PBG sample obtained within 2 hours of birth.
Hoops
Debra
D
Mother-Baby Unit, Saint Luke's Hospital of Kansas City, Kansas City, Missouri, USA.
Roberts
Patrice
P
Van  Winkle
Elizabeth
E
Trauschke
Kelly
K
Mauton
Nicole
N
DeGhelder
Susan
S
Scalise
Angela
A
Jackson
Sarah
S
Cato
Deborah
D
Roth
Christina
C
Jones
Anna
A
Kautz
Martina
M
Whaley
Leah
L
D001786:Blood Glucose / Q000032:analysis*; D003955:Diagnostic Tests, Routine / Q000379:methods; D005951:Glucose Tolerance Test / Q000451:nursing*; D006801:Humans; D007003:Hypoglycemia / Q000175:diagnosis* / Q000451:nursing*; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000175:diagnosis / Q000451:nursing; D017283:Neonatal Nursing / Q000379:methods*; D024802:Nurse's Role; D009733:Nursing Diagnosis / Q000379:methods*; D047929:Term Birth; D014481:United States
D001786:Blood Glucose