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Hypoglycemia in newborn infants at risk

D Jonas1, W Dietz1, B Simma1

  • 1Department of Pediatrics, Academic Teaching Hospital, Landeskrankenhaus Feldkirch, Austria.

Klinische Padiatrie
|August 26, 2014
PubMed

Insights

Hypoglycemia screening in at-risk infants, including those of diabetic mothers, showed a low incidence. The study suggests current screening protocols may not be justified due to the low yield and potential harm from blood draws.

Area of Science:

  • Neonatal Medicine
  • Pediatric Endocrinology

Background:

  • Infants of diabetic mothers (IDM), large for gestational age (LGA), small for gestational age (SGA), and late preterm (LPT) infants are at increased risk for hypoglycemia.
  • A new guideline for screening these at-risk infants was implemented and evaluated.

Purpose of the Study:

  • To determine the incidence and consequences of hypoglycemia in at-risk infants.
  • To assess the impact of a new screening guideline on hypoglycemia detection and management.

Main Methods:

  • A retrospective analysis of 145 infants screened between January 1 and December 31, 2012.
  • Blood glucose screening initiated within 90 minutes of birth, with subsequent measurements before feedings.
  • Hypoglycemia defined as blood glucose < 40 mg/dL, with infants monitored for at least 24 hours or until glucose levels stabilized.

Main Results:

  • Out of 1074 infants, 259 (24.1%) were identified as at-risk, with 145 included in the analysis.
  • 17 infants (11.7%) experienced 19 episodes of hypoglycemia.
  • 6 infants (35%) required transfer, one for clinical signs and five per protocol; 54 procedures were needed per detected episode.

Conclusions:

  • The incidence of hypoglycemia in this large group of at-risk infants is low.
  • Routine screening of such a broad group may not be justified due to the low incidence and the significant number of blood withdrawals required, potentially causing harm.
Abstract

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