Risk Factor Assessment and the Incidence of Neonatal Hypoglycemia in the Postnatal Period

Özet

Objectives: The aim of this study was to evaluate risk factors used for the assessment of neonatal hypoglycemia and to examinethe follow-up outcomes observed in the first 48 hours of postnatal life.Methods: The records of infants born between 2015 and 2017 (3 years) at Şişli Hamidiye Etfal Training and Research Hospital whohad a blood glucose level test performed within the first 24 hours after birth and who had follow-up results for 48 hours wereincluded in the study. Data of gestational age; birth weight; gender; antenatal, natal and postnatal characteristics; blood glucosemeasurement method and time during the first 48 hours postpartum; glucose values and follow-up; nutritional status; and theneed for hospitalization due to a low blood glucose value were recorded. Groups were created based on data of a diabetic mother,small for gestational age (SGA), large for gestational age (LGA), late preterm birth (34-36+6/7 gestational weeks), fetal distress,and feeding intolerance. Blood glucose measurement values and reasons for hypoglycemia and assessment were compared insubgroups.Results: The data of 9480 infants were reviewed and included in the study. It was determined that blood levels were checked in28.7% (n=2720). The mean birth weight and gestational age of the infants was 3143±804 g and 37.7±2.5 weeks, respectively. In thestudy group, 54.7% were male, and 57.5% were delivered via cesarean section. The most frequent factors prompting blood glucosemeasurement were LGA status (25.9%), prematurity (18%), transient tachypnea (17.3%), and SGA status (11.6%). Results revealedthat the blood glucose values of 2009 (73.9%) infants were within normal limits, and there was no further monitoring of bloodglucose level during the first 48 hours. In 711 (26.1%), a low blood glucose level finding led to follow-up assessment. The incidenceof hospitalization with a preliminary diagnosis of hypoglycemia was 2.5% (n=67). Subgroup analysis indicated that at the first hour,the mean blood glucose value of the patients with multiple factors that were risks for hypoglycemia suggesting further evaluationwas lower than those with transient tachypnea and fetal distress (p<0.001), and the mean blood glucose value of premature andLGA neonates were significantly lower than the infants of diabetic mothers at the sixth hour (p<0.001).Conclusion: In the postnatal period, the rate of monitoring blood glucose levels in newborn babies was found to be 28.7% andthe most commonly predicted risk factor was LGA babies. The frequency of postpartum hospitalization due to hypoglycemia wasfound to be 2.5%, and blood sugar levels were lower in the first hour in groups with multiple causes.