Neonatal hypoglycemia in a tertiary care hospital
Journal Title: MedPulse -International Medical Journal - Year 2015, Vol 2, Issue 7
Abstract
Introduction: Neonatal Hypoglycemia (NH) is a common condition influenced in newborn by prematurity, macrosomia, intrauterine growth restriction, maternal diabetes mellitus, sepsis etc. NH is known to cause brain dysfunction and neuromotor developmental retardation in both symptomatic and asymptomatic cases. Hence a high risk neonate requires an aggressive blood sugar monitoring and management in order to reduce neonatal mortality and neurological sequelae in later life. Aims and Objectives: To find out incidence, risk factors (antenatal and postnatal), clinical features and outcome associated with NH in a tertiary care hospital. Material and Methods: This prospective study was conducted in pediatrics department in tertiary care centre from Jan 2012 to June 2013. All neonates born at tertiary hospital either by vaginal or LSCS delivery during study period were included and those born outside were excluded. Out of 8000 neonates delivered, 400 neonates were admitted and screened for hypoglycemia at 0,3,6,12,24,48 and 72 hr of life with operational threshold for hypoglycemia of blood glucose level < 40 mg/dl formed the study group. Observation and Results: Out of 8000 neonates delivered in our institute, 400 neonates were admitted in SCNU and Pediatrics wards, of which 106 neonates were detected to have hypoglycemia. The overall incidence of NH was found to be 13.25/ 1000 live birth. Among 106 with NH 74 (69.8%) neonates were preterm, 12 (11.32%) were full term, 20 (18.86%) were post term. Antenatal risk factors associated with hypoglycemia were diabetes in 18(36%), Toxemia of pregnancy in 12(24%) PROM in 8 (16%), fever in 6 (12%), dysuria in 4 (8%), APH in 2 (4%). Neonatal risk factors associated with hypoglycemia were birth asphyxia in 46 (43.39%), RDS in 31 (29.24%), Septicemia in 20 (18.8%), meningitis in 9(8.49%) neonates. Conclusion: NH was most commonly associated with prematurity and postmaturity, RDS and sepsis accommodate as most common neonatal risk factor and babies of diabetic mother and eclampsia formed most common antenatal risk factor for NH. Neonatal mortality was 17.9% in present study in neonates with hypoglycemia. Hence above categories of neonates (High risk neonate) requires an aggressive blood sugar monitoring and management in order to reduce neonatal mortality and neurological sequelae in later life.
Authors and Affiliations
Tiple Nishikant, Kamble Milind, Chavan Ravindra
Keywords
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