Predictors and Frequency of Convulsions in Neonates with Neonatal Hypoglycemia; a Hospital-Based Study

Abstract

AbstractIntroduction: Transient low blood glucose levels are common in neonates as the source of glucose at delivery changes from a continuous supply from the mother to the intermittent supply from feeds. The overall incidence of hypoglycemia has been estimated at 1 to 5 per 1,000 live births, but it is higher in at-risk populations. Aim of study: To identify predictors, risk factors and frequency of convulsion in hypoglycemic neonatesPatients and methods: A cross sectional study of analytic purpose was performed on 186 hypoglycemic neonates admitted to the neonatal intensive care unit in Maternity Hospital and Raparin Pediatric Teaching Hospitals in the period from February1st 2010 to June 1st 2011 in Erbil governorate. Neonates presented with symptomatic hypoglycemia and blood glucose less than 30 mg/dl in the first day and less than 40mg/dl after first day were included in the study according to American Academy of Pediatrics criteria of neonatal hypoglycemia. The reading was taken while the neonate was just presented with the symptoms and had not received any glucose solutions.Results: Overall 4768 neonates admitted to the NICU during the study period; 186(3.9 %) developed hypoglycemia. 111(59.67%) of them were males and 75(40.33%) were female. Convulsions developed in 34(18.27%) of them; out of 34 convulsing hypoglycemic neonates, 20(58%) were males and 14(41%) were females with a male to female ratio of 1.42:1. Low birth weight hypoglycemic neonates more affected with convulsions 25(73.5%) versus normal birth weight neonates 9(26.7%). Premature babies also more affected with convulsions 20(58%) versus appropriate for gestational age babies 14(41.17%).Conclusions: Neonatal hypoglycemia is a common finding in neonatal care units and may lead to convulsions if not identified early and treated properly, and it’s more common in premature, small for gestational ages, infants of diabetic mother and mothers receiving glucose infusions before delivery, while jitteriness, lethargy and apnea were features that most commonly precede neonatal convulsion secondary to hypoglycemia Key words: neonates, premature, hypoglycemia, convulsions