Incidence, Predictors, and Outcomes of Hypoglycemia Among At-Risk Neonates

Praneet Kumar, Shakal Narayan Singh, Shalini Tripathi, Mala Kumar

Abstract

Background and Aim: Hypoglycemia is less studied in healthy at-risk neonates compared with hospitalized neonates, especially in the first few days of life. Hypoglycemia can have serious neurologic implications later in life. This study was conducted to assess the incidence, predictors, and outcomes of hypoglycemia among at-risk neonates and its neurologic implications during the first few months of life.

Materials and Methods: At-risk neonates were screened for hypoglycemia at 2, 6, 12, 24, 48, and 72 hours of life. They were subjected to neurodevelopmental assessment at 3 and 6 months of life and were evaluated based on the Rashtriya Bal Swasthya Karyakram developmental scale.

Results: Of the 483 neonates, 65 (13.5%) neonates had hypoglycemia. Low birth weight, small for gestational age, maternal hypothyroidism, maternal chorioamnionitis, delayed first feed, feeding of milk other than breast milk, low frequency of feed, > 4 hours of interval between night feeds, lack of support from health worker for early feeding initiation, and maternal sedation were predictors of hypoglycemia. At the 3-month follow-up, 4 of the 55 neonates showed a developmental delay, which was observed at 6 months too. Vision (3/4) was the most commonly affected domain.