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Hypoglycemia in small for gestational age babies.
M A Bhat1, P Kumar, A Bhansali
1Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh.
Indian Journal of Pediatrics
|August 10, 2000
Summary
Hypoglycemia is common in small for gestational age (SGA) babies, occurring in 25.2% within 24 hours. Early oral feeds and avoiding maternal IV fluids may reduce risk.
Area of Science:
- Neonatal Medicine
- Pediatric Endocrinology
- Clinical Chemistry
Background:
- Small for gestational age (SGA) neonates are at increased risk for metabolic disturbances.
- Hypoglycemia is a significant concern in this vulnerable population.
- Understanding incidence and risk factors is crucial for timely intervention.
Purpose of the Study:
- Determine the incidence and risk factors of hypoglycemia in SGA infants.
- Compare the accuracy of haemoglucotest strips versus the glucose-hexokinase method for blood glucose measurement.
- Evaluate insulin and cortisol responses in hypoglycemic SGA infants.
Main Methods:
- Prospective longitudinal study of 127 consecutively born SGA infants over six months.
- Blood glucose monitored for hypoglycemia in the first 48 hours of life.
- Plasma insulin and cortisol levels measured during hypoglycemic episodes and compared to controls.
Main Results:
- Overall incidence of hypoglycemia was 25.2%, with 98% occurring within the first 24 hours.
- Mothers of hypoglycemic infants received IV fluids more frequently during labor.
- Hypoglycemic infants were sicker, with delayed oral feeding initiation (37% vs. 63%).
- Significantly higher plasma insulin/glucose ratio in hypoglycemic infants; cortisol levels were similar.
Conclusions:
- SGA infants have a high propensity for developing hypoglycemia within the first 24 hours of life.
- Maternal IV fluid administration and delayed oral feeding are associated risk factors.
- Further research into optimal feeding strategies and monitoring is warranted.