The Clinical Value of Capillary Blood Cartridge-Based Testing in Neonatal Jitteriness: A Re-Evaluation of the...

This study assessed the utility of capillary blood cartridge-based analysis in evaluating neonatal jitteriness (NJ).

In this retrospective study, we compared outcomes between neonates (37-41 weeks of gestation) diagnosed with neonatal jitteriness (NJ) within the first 72 h of life and a control group of healthy neonates (GA 37-41 weeks) with an uneventful perinatal course and no signs of jitteriness.

Each group included 101 neonates. Jittery neonates had a higher proportion of males (70.3% vs. 50.5%, p = 0.004), a lower mean gestational age (38.8 vs. 39.2 weeks, p = 0.002), and a higher rate of emergency cesarean deliveries (14.9% vs. 3.0%, p = 0.003). The logistic regression identified male sex (OR = 2.5, p = 0.007) and in utero selective serotonin reuptake inhibitor (SSRI) exposure (OR = 9.0, p = 0.005) as significant risk factors for NJ. The capillary blood parameters, except glucose levels, did not differ significantly between the neonates admitted to the NICU and those discharged. Hypoglycemic jittery neonates were 10 times more likely to require NICU admission compared to their non-hypoglycemic counterparts (OR = 10.9, 95% CI: 2-59.5, p = 0.006).

Point-of-care glucose testing using a bedside glucometer may be sufficient for the evaluation of neonatal jitteriness, as capillary blood cartridge-based testing did not offer an additional diagnostic value.

NJ is often viewed as a self-resolving benign phenomenon; however, in certain cases, it can be an indicator of an underlying pathology. There is substantial evidence linking the maternal use of SSRIs or SNRIs during pregnancy with the occurrence of NJ in newborns as well as an association between hypoglycemia and NJ.

This study is the first to evaluate the clinical utility of systematic capillary blood cartridge-based testing in jittery neonates using a relatively large cohort. Male neonates were disproportionately represented among cases of NJ. Healthy neonates with jitteriness had normal electrolytes, with hypoglycemia as the only concern. A glucometer test may suffice for evaluation, but those who are small for their gestational age or have initial hypoglycemia require a routine follow-up due to a higher risk of NICU admission.