Incidence of neonatal hypoglycemia in babies identified as at risk.
OBJECTIVE
Routine blood glucose screening is recommended for babies at risk of neonatal hypoglycemia. However, the incidence of hypoglycemia in those screened is not well described. We sought to determine the incidence of hypoglycemia in babies identified as being at risk, and also to determine differences in incidence between at risk groups.


METHODS
Infants (n = 514) were recruited who were born in a tertiary hospital, ≥35 weeks gestation and identified as at risk of hypoglycemia (small, large, infant of a diabetic, late-preterm, and other). Blood glucose screening used a standard protocol and a glucose oxidase method of glucose measurement in the first 48 hours after birth.


RESULTS
One-half of the babies (260/514, 51%) became hypoglycemic (<2.6 mM), 97 (19%) had severe hypoglycemia (≤2.0 mM), and 98 (19%) had more than 1 episode. The mean duration of an episode was 1.4 hours. Most episodes (315/390, 81%) occurred in the first 24 hours. The median number of blood glucose measurements for each baby was 9 (range 1-22). The incidence and timing of hypoglycemia was similar in all at risk groups, but babies with a total of 3 risk factors were more likely to have severe hypoglycemia.


CONCLUSIONS
Hypoglycemia is common amongst babies recommended for routine blood glucose screening. We found no evidence that screening protocols should differ in different at risk groups, but multiple risk factors may increase severity. The significance of these hypoglycemic episodes for long-term outcome remains undetermined.
Newborn Intensive Care Unit, Waikato District Health Board, Hamilton, New Zealand.
Deborah L
DL
Harris
Philip J
PJ
Weston
Jane E
JE
Harding
D001724:Birth Weight; D001786:Blood Glucose / Q000032:analysis*; D016640:Diabetes, Gestational; D005260:Female; D005947:Glucose / Q000378:metabolism; D006801:Humans; D007003:Hypoglycemia / Q000175:diagnosis* / Q000453:epidemiology*; D015994:Incidence; D007231:Infant, Newborn; D008297:Male; D009359:Neonatology / Q000379:methods; D011247:Pregnancy; D012306:Risk; D012307:Risk Factors; D013997:Time Factors
D001786:Blood Glucose; D005947:Glucose