Prophylactic dextrose gel use in newborns at risk for hypoglycemia

Area of Science:

• Neonatal Medicine
• Endocrinology
• Pediatrics

Background:

• Hypoglycemia is a common metabolic disturbance in newborns.
• Infants of diabetic mothers, large for gestational age (LGA), and small for gestational age (SGA) infants are at higher risk.
• Effective interventions are needed to manage neonatal hypoglycemia.

Purpose of the Study:

• To evaluate the effectiveness of prophylactic dextrose gel in reducing short-term adverse outcomes in high-risk neonates.
• To compare outcomes between neonates who received prophylactic dextrose gel and those who did not.

Main Methods:

• Retrospective, single-center observational study.
• Included neonates at risk for hypoglycemia (infants of diabetic mothers, LGA, SGA) born between January 2015 and May 2023.
• Compared outcomes between a pre-dextrose gel period (n=788) and a dextrose gel period (n=1495).

Main Results:

• Prophylactic dextrose gel use was associated with a significant decrease in NICU admissions for hypoglycemia (2.7% vs 6.5%).
• The incidence of hypoglycemia was lower in the dextrose gel group (32% vs 43.3%).
• Exclusive breastmilk use at discharge was higher in infants who received dextrose gel (47% vs 37.3%).

Conclusions:

• Prophylactic dextrose gel administration is an effective strategy for managing high-risk newborns.
• Dextrose gel improves key short-term outcomes, including reduced hypoglycemia and increased breastfeeding.
• This intervention shows promise in enhancing neonatal care for at-risk populations.