Evaluation of a Simple Weight-Based Screening Tool for Asymptomatic Neonatal Hypoglycemia

The objective of this study was to determine if the use of weight-based criteria to screen for asymptomatic hypoglycemia is consistent with using percentile curves to determine small and large for gestational age status. A retrospective chart review of 892 term infants in the normal nursery was performed. The degree of agreement in screening recommendations between weight-based criteria and the Lubchenco, Oken, and Olsen percentile curves was determined using Cohen's κ and McNemar's test. Agreement was lower between Lubchenco and Olsen or Oken (0.470, 0.509, respectively) than with weight-based criteria (Lubchenko = 0.532; Oken = 0.566; and Olsen = 0.582). Weight-based criteria recommended screening 12% and 7% fewer patients than Lubchenko and Oken, respectively (P < .001), but was equally likely to screen infants as Olsen (P = .579). Simple weight-based criteria for asymptomatic hypoglycemia screening can identify infants at risk for hypoglycemia in a manner consistent with current guidelines.