title: Hypoglycaemia and hypocalcaemia as determinants of admission birth weight criteria for term stable low risk macrosomic neonates.
abstract: BACKGROUND
  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.
  
  
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  the study identified 4275 g as new admission birth weight criteria for stable term low risk IGA's admission.
authors.affiliation: Department of Paediatric, Coast Provincial Hospital, Mombasa, Kenya.
authors.forename: Victor L
authors.initials: VL
authors.lastname: Bandika
authors.affiliation: School of Child and Adolescents, University of Nairobi, Kenya.
authors.forename: Fred N
authors.initials: FN
authors.lastname: Were
authors.affiliation: School of Child and Adolescents, University of Nairobi, Kenya.
authors.forename: Eseli D
authors.initials: ED
authors.lastname: Simiyu
authors.affiliation: School of Child and Adolescents, University of Nairobi, Kenya.
authors.forename: Donald P
authors.initials: DP
authors.lastname: Oyatsi
mesh_terms: D000328:Adult; D001724:Birth Weight; D016022:Case-Control Studies; D002648:Child; D005260:Female; D005320:Fetal Macrosomia / Q000453:epidemiology*; D006801:Humans; D006996:Hypocalcemia / Q000453:epidemiology*; D007003:Hypoglycemia / Q000453:epidemiology*; D015994:Incidence; D007231:Infant, Newborn; D007630:Kenya / Q000453:epidemiology; D008297:Male; D010298:Parity; D010343:Patient Admission / Q000706:statistics & numerical data*; D011247:Pregnancy; D011248:Pregnancy Complications; D011446:Prospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Hypocalcaemia; Hypoglycemia; Macrosomia; birth weight