Screening For Hypoglycemia In Late Preterm Andterm Neonates

Abstract

Background: Neonatal hypoglycemia, a common metabolic problem, often goes unnoticed owing to lack of specific symptoms. We designed this study to assess the incidence of hypoglycemia in healthy term and late pre term babies on exclusive breast feeding. Some studies have reported that long term neurological sequel may be seen to the extent of 35 % of newborns with symptomatic h ypoglycaemia and up to 20% in those with asymptomatic hypoglycaemia OBJECTIVES OF THE STUDY: 1. To determine incidence of hypoglycaemia in neonates of 34 40 weeks of gestational age who do not require NICU admission and are kept in post natal ward with mother 2. To compare incidence of hypoglycaemia in late pre term and term neonates of 34 40weeks of gestational age METHODOLOGY In this prospective comparative analytical study, a convenient sample of 196 neonates of 32 40 gestational ag e delivered in Shri B.M. Patil Medical College, Hospital and Research Centre who do not require NICU admission and are kept in postnatal wards with mother will be included. GRBS will be checked with portable glucometer at 1 hour, 2 hours, 6 hours, 24 hou rs and 48 hours of life and recorded. If blood glucose level is < 45 mg/dl, sample will be collected for Laboratory evaluation of RBS.RESULTS  Out of 98 babies in each group, incidence of hypoglycaemia was 19.4% and 30.6% in term and late preterm babies respectively.  Hypoglycaemia was more common in females and males in term & late preterm babies respectively.  Hypoglycaemia was statistically significant in LBW & decreased gestational age babies.  Incidence of hypoglycaemia in SGA term & late preterm babies was 31.6% and 40.0% respectively.  Incidence of hypoglycaemia in IUGR term & late preterm babies was 15.8% and 36.7% respectively.  Incidence of hypoglycaemia in LGA term & late preterm babies was 15.8% and 6.7% respectively.  Most common feeding complaint on day 1 in term and late preterm babies was reduced sucking.  Most common feeding complaint on day 2 in term and late preterm babies was decreased production and reduced sucking respectively. CONCLUSION The incidence of hypoglycaemia in healthy newborns on exclusive breastfeeding was 19.4% & 30.6% in term and late preterm babies respectively. There was correlation between hypoglycaemia and birth weight & gestational age. Association between hypoglycaemia and SGA,IUGR & LGA was not statistically significant. About 14 & 22 of newborns developed hypoglycaemia at 1 hour of life. We conclude that healthy newborns in postnatal wards can be exclusively breastfed, but there is need to closely monitor their blood glucose levels at least infirst 48 hrs to prevent hypoglycaemia and potential neurodevelopment damage damage, and asymptomatic hypoglycemia in newborns can be managed with frequent breastfeeds.So more studies with larger sample size are required to see the association between these risk factors and hypoglycemia. Also more studies with long-term follow up are required to evaluate impact of this asymptomatic hypoglycemia on this population.