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Metabolic screening and postnatal glucose homeostasis in the newborn

David H Adamkin1

  • 1Division of Neonatal Medicine, Department of Pediatrics, University of Louisville, 571 South Floyd Street, Suite 342, Louisville, KY 40202, USA.

Pediatric Clinics of North America
|April 4, 2015
PubMed

Insights

Inherited metabolic diseases are a common cause of neonatal illness. Current newborn screening for hypoglycemia uses two conflicting definitions, complicating management decisions for at-risk infants.

Area of Science:

  • Neonatology
  • Genetics
  • Public Health

Background:

  • Inherited metabolic diseases are a significant cause of neonatal disease.
  • Newborn screening programs are highly successful public health initiatives.
  • Screening for hypoglycemia is routine for at-risk newborns.

Purpose of the Study:

  • To highlight the collective impact of inherited metabolic diseases in neonates.
  • To address the confusion surrounding the definition of clinically significant hypoglycemia.
  • To compare the two main methods for defining hypoglycemia in newborns.

Main Methods:

  • Review of current newborn screening practices for hypoglycemia.
  • Analysis of two competing methods for defining hypoglycemia: metabolic-endocrinologic versus outcome-based.
  • Discussion of the implications for clinical management.

Main Results:

  • Inherited metabolic diseases are collectively more common in neonates than often recognized.
  • There are two primary, conflicting approaches to defining hypoglycemia.
  • These differing definitions lead to varied management thresholds.

Conclusions:

  • A unified definition for hypoglycemia is needed in neonatology.
  • Clarifying hypoglycemia thresholds can improve management of at-risk newborns.
  • Further research is required to reconcile the competing definitions.

Keywords:
Hypoglycemia screening and managementNewborn metabolic screeningTandem mass spectrometry

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