Evaluation of Maternal and Neonatal Risk factors for Neonatal Hypoglycemia


Abstract:Background; Hypoglycemia is the most common metabolic disorder in the newborn.Objectives: to identify its prevalence, risk factors, type of presentation, determine treatment schedule and prognosis.Patient and methods: A case control study of ninety six neonates found to have hypoglycemia after screening of six hundred twelve neonates who were admitted to special care baby unit (SCBU) of child’s central teaching hospital over the period between 1st of December 2007 and 30thof June 2008, and ninety six neonates were considered as control from these neonates who were admitted for other reasons but had no hypoglycemia, Blood sugar levels regarded significant in our study were less than 35 mg/dl at 1–3 hrs of life, less than 40 mg/dl at 3–24 hrs of life and less than 45 mg/dl after first 24 hrs of life. History was taken for all neonates, systemic examination and serial measurements of blood sugar was undertaken in the first 7 days of life. Packed red cell volume (PCV) was done to all neonates and blood culture was done if sepsis was a suspicion.Results: Significant risk factors were: low birth weight, large for date, prematurity, respiratory distress, chronic maternal illnesses diabetes mellitus, perinatal asphyxia and tocolytic drug intake, The first 24 hrs of life were the most critical period for developing hypoglycemia, 43.3% of neonates were asymptomatic and 56.7% were symptomatic. The most frequent symptoms were lethargy, poor feeding, jitteriness, respiratory distress and seizure (62.5%, 26.4%, 22.9%, 20.8% and 16.6% respectively), all newborn neonates respond to treatment and nine neonates died for reasons other than hypoglycemia.Conclusion: It is important to identify hypoglycemia in neonates with risk factors as early as possible for proper management to decrease morbidity and mortality. Key words: neonatal hypoglycemia, maternal diabetes mellitus