A Survey of the Current Practice for Testing for Neonatal Hypoglycaemia in Aotearoa, New Zealand

Neonatal hypoglycaemia is the most common metabolic disturbance in newborns and can lead to brain injury. However, the feasibility of implementing a national recommendation to use accurate testing methods to avoid under- and over-diagnosis depends on current practise, preferences, and resources. We therefore sought to identify current testing practises for neonatal hypoglycaemia to inform recommendations for testing, including devices and timing.

An online survey was sent to relevant clinical unit leaders across the 19 health regions of New Zealand, and to members of the New Zealand College of Midwives who provide home birth services. These individuals were asked to complete the survey themselves or identify the appropriate practitioner in their unit to complete it.

From 28th August to 12th December 2023, we obtained 71 responses, which came from more than one profession from all but one health region. The most commonly used devices for measuring glucose concentrations in capillary blood samples were blood gas analysers (20/65, 31%) and i-STAT (12/65, 18%). Devices used did not differ among professions, but the use of blood gas analysers was not reported in primary units. i-STAT (22/80, 28%) and blood gas analyser (19/80, 24%) were also the most preferred testing devices. The timing of blood sampling was reported to be similar for > 70% of respondents.

Most healthcare professionals use and prefer accurate blood sampling devices, suggesting implementing a recommendation to use these is likely feasible. However, guidance on the timing of testing is needed.