Neonatal Hypoglycemia in a Tertiary Care Hospital

How to site this article: Tiple Nishikant, Kamble Milind, Chavan Ravindra, Naik Shilpa . Neonatal hypoglycemia in a tertiary care hospital. MedPulse – International Medical Journal July 2015; 2(7): 419-423. http://www.medpulse.in (accessed 28 July 2015). Research Article Neonatal hypogly cemia in a tertiary care ho spital Tiple Nishikant 1* , Kamble Milind 2 , Chavan Ravindra 3 , Naik Shilpa 4 1 Assistant Professor, 2 Professor and HOD, 3 Associate Professor, 4 Medical Officer, Department of Pediatrics, Shri.Vasantrao Naik Government Medical College, Yavatmal, Maharashtra, INDIA. Email: [email protected] Abstract Introduction: Neonatal Hypoglycemia (NH) is a common condition influenc ed in newborn by prematurity, macrosomia, intrauterine growth restriction, maternal diabetes mellitus, sepsis etc. NH is known to cause brain dysfunction and neuromotor developmental retardation in both symptomatic and asymptomatic cases. Hence a high risk neonate requires an aggressive blood sugar monitoring and management in order to reduce neon atal mortality and neurological sequelae in later life. Aims and Objectives: To find out incidence, risk factors (antenatal and postnatal), clinical features and outcome associated with NH in a tertiary care hospital. Material and Methods: This prospective study was conducted in pediatrics department in tertiary care centre from Jan 2012 to June 2013. All neonates born at tertiary hospital either b y vaginal or LSCS delivery during study period were included and those bo rn outside were excluded. Out of 8000 neonates delivered, 400 neonates were admitte d and screened for hypoglycemia at 0 ,3,6,12,24,48 and 72 hr of life with operational threshold for hypoglycemia of blood glucose level < 40 mg/dl formed the study group. Observation and Results: Out of 8000 neonates delivered in our institute, 400 neonates were admitted in SCNU and Pediatrics wards, of which 106 neonates were detected to have hypoglycemia. The overall incidence of NH was found to be 13.25/ 1000 live birth. Among 106 with NH 74 (69.8%) neonates were preterm, 12 (11.32%) were full term, 20 (18.86%) were post term. Antenatal risk factors associated with hypoglycemia were diabetes in 18(36%), Toxemia of pregnancy in 12(24%) PROM in 8 (16%), fever in 6 (12%), dysuria in 4 (8%), APH in 2 (4%). Neonatal risk factors associated with hypoglycemia were birth asphyxia in 46 (43.39%), RDS in 31 (29.24%), Septicemia in 20 (18.8%), meningitis in 9(8.49%) neonates. Conclusion: NH was most commonly associated with prematurity and postmaturity, RDS and sepsis accommodate as most common neonatal risk factor and babies of diabetic mother and eclampsia formed most common antenatal risk factor for NH. Neonatal mortality was 17.9% in pr esent study in neonates with hypoglycemia. Hence above categories of neonates (High risk neonate) requires an aggressive blood sugar monitoring and management in order to reduce neonatal mortality and neurological sequelae in later life. Keywords: Neonatal h ypoglycaemia . * Address for Correspondenc e: Dr. Nishikant Tiple, Assistant Professor, Department of P ediatrics, Shri Vasantrao Naik Government Medical College, Yavatmal-445001, Maharashtra. INDIA. Email: [email protected] Received Date: 11/07/2015 Revised Date: 20/07/2015 Accepted Date: 23/07/2015 INTRODUCTION Neonatal hypoglycemia (NH) is common condition influenced in newborn by factors like birth weight, gestational age, perinatal complications, mode of delivery and feeding behaviour 1,2,3 . The stated incidence is estimated at 1 to 5 per 1000 births, but it is significantly higher in certain subgroups, 8% in LGA (large for gestational age) infants and about 15% in SGA (small for gestational age) infants (i.e, those with intrauterine growth retardation) 2 . Hypoglycemia in neonates can be symptomatic or asymptomatic. The most common symptoms such as convulsion, apathy, hypotonia, coma, refusal to feeds, cyanosis, high pitced cry, and hypothermia are very nonspecific and especially in small sick neonates, these symptoms may be easily missed 4,5,6 . NH can be easily treated in most cases if it is recognized, but untreated hypoglycemia can have serious consequences for the infant as glucose is the major substrate for energy in all organs and almost exclusively used for cerebral metabolism 7 . Hypoglycemia is known to be associated with brain dysfunction and neuromotor developmental retardation in both symptomatic and asymptomatic cases 8 . Hence this study was planned to evaluate incidence, etiology, clinical features and outcome of NH. Access this article online Quick Response Code: Website: www.medpulse.in DOI: 25 July 2015

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Neonatal Hypoglycemia in a Tertiary Care Hospital