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Biochemical Measurement of Neonatal Hypoxia
13:13

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Neonatal Hypoglycemia: A Systematic Review of International and Local Clinical Guidelines with Clinical Implications

Camelia Rusu1,2, Melinda Matyas3, Boris W Kramer4

  • 1Department of Medical Disciplines, University of Oradea, 410073 Oradea, Romania.

Journal of Clinical Medicine
|May 27, 2026
PubMed

Insights

Neonatal hypoglycemia management guidelines vary internationally. This review compares key guidelines, finding consensus on core principles but highlighting differences in screening and treatment thresholds for newborn blood glucose levels.

Area of Science:

  • Neonatal Medicine
  • Endocrinology
  • Clinical Guidelines

Background:

  • Neonatal hypoglycemia is a frequent metabolic issue in newborns.
  • Existing international and local guidelines present inconsistencies in screening, thresholds, and management.

Purpose of the Study:

  • To systematically review and compare international and local clinical guidelines for neonatal hypoglycemia management.
  • To identify variations and commonalities in risk assessment, screening, and treatment protocols.

Main Methods:

  • Systematic comparative review of major international and regional guidelines.
  • Analysis of recommendations on risk factors, screening protocols, blood glucose thresholds, and NICU admission criteria.

Main Results:

  • All reviewed guidelines advocate for targeted screening of at-risk neonates and prompt treatment of symptomatic hypoglycemia.
  • Significant variation exists in the recommended timing for initial blood glucose measurement, screening frequency, and minimum glucose thresholds for intervention.
  • Current guidelines support oral dextrose gel (40%) as a primary treatment for specific cases.

Conclusions:

  • Despite numerical discrepancies, major guidelines align on fundamental principles for managing neonatal hypoglycemia.
  • Further research is needed to standardize intervention thresholds and optimize blood glucose measurement strategies.

Keywords:
40% dextrose gelNICU admissionclinical guidelinesneonatal hypoglycemianewbornoperational thresholdspersistent hypoglycemiarisk factorsscreening

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