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Development and validation of a risk prediction model for early-onset hypoglycemia in preterm infants

Rongdan Li1, Chunmei He1, Mei Luo1

  • 1Department of Neonatology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.

The Journal of Maternal-Fetal & Neonatal Medicine : the Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians
|January 29, 2026
PubMed

Insights

Early-onset hypoglycemia in preterm infants can cause neurodevelopmental issues. A new predictive model identifies six risk factors, offering a tool for early intervention and risk stratification.

Area of Science:

  • Neonatal Medicine
  • Metabolic Disorders
  • Predictive Analytics

Background:

  • Early-onset hypoglycemia is a common metabolic complication in preterm infants.
  • It is associated with adverse neurodevelopmental outcomes.
  • Accurate risk prediction is crucial for timely clinical intervention.

Purpose of the Study:

  • To develop and validate a predictive model for early-onset hypoglycemia in preterm infants.
  • To identify independent risk factors associated with this condition.

Main Methods:

  • A retrospective study of 436 preterm infants was conducted.
  • Data were divided into training and validation sets.
  • LASSO and multivariate logistic regression were used to develop a nomogram model, validated with calibration plots, ROC curves, and decision curve analysis (DCA).

Main Results:

  • 124 preterm infants (28.44%) developed hypoglycemia within 48 hours of birth.
  • Six independent risk factors were identified: reduced gestational age, multiple births, cesarean delivery, maternal gestational diabetes, gestational hypertension, and postnatal abdominal distension.
  • The model showed strong discriminative power (AUC 0.802 training, 0.829 validation) and clinical utility via DCA.

Conclusions:

  • The developed model shows promising predictive ability for early-onset hypoglycemia in preterm infants.
  • It can serve as a preliminary tool for risk stratification.
  • External validation in prospective, multicenter studies is needed for clinical translation.
Abstract

Keywords:
Preterm infantshypoglycemiainternal validationlogistic regressionnomogramrisk prediction model

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