title: Very low birth weight preterm infants are at risk for hypoglycemia once on total enteral nutrition.
abstract: OBJECTIVE
  To determine the occurrence of hypoglycemic episodes in very low birth weight preterm infants under total enteral nutrition and identify potential risk factors.
  
  
  METHODS
  In this single centre cohort study, we analyzed the patients' charts of preterm infants with a gestational age <32 weeks (n = 98). Infants were analyzed in two groups (group 1: birth weight <1000 g, n = 54; group 2: birth weight 1000-1499 g, n = 44). A total of 3640 pre-feeding blood glucose measurements were screened. Risk factors for the development of hypoglycemia were identified by linear and multiple logistic regression analyses.
  
  
  RESULTS
  In group 1, 44% (24 of 54) of infants experienced at least one asymptomatic episode of blood glucose <45 mg/dl (<2.5 mmol/l) as compared with 23% (10 of 44) in group 2. Regression analysis identified low gestational age and high carbohydrate intake as potential risk factors for the development of hypoglycemia.
  
  
  CONCLUSIONS
  Our results indicate that numerous preterm infants experience hypoglycemic episodes once on total enteral nutrition, especially those who are <1000 g at birth and those with a higher carbohydrate intake. Further studies evaluating a possible impact of these common although asymptomatic episodes on later development could help to better define thresholds that should be considered as "hypoglycemia" in this population.
authors.affiliation: Division of Neonatology, University Children's Hospital, Perinatal Center Grosshadern, Ludwig-Maximilian-University, Munich, Germany. alex.staffler@asbz.it
authors.forename: Alex
authors.initials: A
authors.lastname: Staffler
authors.forename: Mathias
authors.initials: M
authors.lastname: Klemme
authors.forename: Elisa
authors.initials: E
authors.lastname: Mola-Schenzle
authors.forename: Rashmi
authors.initials: R
authors.lastname: Mittal
authors.forename: Andreas
authors.initials: A
authors.lastname: Schulze
authors.forename: Andreas W
authors.initials: AW
authors.lastname: Flemmer
mesh_terms: D001724:Birth Weight / Q000502:physiology; D015331:Cohort Studies; D005260:Female; D005865:Gestational Age; D006801:Humans; D007003:Hypoglycemia / Q000151:congenital / Q000453:epidemiology / Q000209:etiology*; D007231:Infant, Newborn; D007234:Infant, Premature / Q000097:blood; D019102:Infant, Very Low Birth Weight / Q000097:blood; D008297:Male; D010288:Parenteral Nutrition / Q000009:adverse effects*; D012307:Risk Factors