Title: Study of Hypoglycemia in Neonates with Low Birth Weight and Very Low Birth Weight in A Tertiary Care Center
Authors: Valinjkar S, Shaha S, Jain H, Doshi A, Tyagi A, Dhingra B
DOI: https://dx.doi.org/10.18535/jmscr/v14i05.03
Abstract
Background: Neonatal hypoglycemia is one of the most common metabolic disorders affecting newborns, particularly those with low birth weight (LBW), very low birth weight (VLBW), small for gestational age (SGA), prematurity, and infants born to diabetic mothers. Following birth, neonates experience an abrupt interruption in maternal glucose supply. This metabolic transition, coupled with immature gluconeogenesis, limited glycogen stores, and increased cerebral glucose demand, predisposes high-risk neonates to hypoglycemia.
Methods: This prospective observational study was conducted over 20 months in a tertiary care center and included 150 high-risk neonates, predominantly from socioeconomically disadvantaged tribal populations. Serial blood glucose monitoring was performed at predefined intervals.
Results: Among the study population, 30% of neonates developed hypoglycemia, while 70% remained normoglycemic. Extremely low birth weight (ELBW ≤1000 g) infants demonstrated a 100% incidence of hypoglycemia. Significant associations were observed between hypoglycemia and birth weight (p = 0.006), gestational size (p = 0.0028), and neonatal sepsis (p < 0.0001). Sepsis was present in 38.46% of neonates and showed a strong correlation with hypoglycemic episodes. No significant association was found with maternal gravida status.
Conclusion: Neonatal hypoglycemia remains a significant concern in LBW and VLBW neonates, particularly among ELBW, SGA, and septic infants. Early identification, routine glucose monitoring, and timely intervention in high-risk groups are essential to prevent adverse neurological outcomes and improve neonatal survival.
Keywords: Neonatal hypoglycemia; Low birth weight (LBW); Very low birth weight (VLBW); Extremely low birth weight (ELBW); Small for gestational age (SGA); Preterm neonates; Sepsis; Glucose homeostasis; Intrauterine growth restriction (IUGR); Neonatal outcomes
References
- Cornblath M. Neonatal hypoglycemia 30 years later: does it injure the brain? Historical summary and present Acta Paediatr Jpn. 1997;39(Suppl 1):S7–S11.
- Zhou W, Yu J, Wu Y, Zhang Hypoglycemia incidence and risk factors assessment in hospitalized neonates. J Matern Fetal Neonatal Med. 2015;28(4):422–425.
- National Neonatology Forum NNPD National Neonatal-Perinatal Database: Report 2002–2003. New Delhi: All India Institute of Medical Sciences; 2005.
- Cornblath M, Hawdon JM, Williams AF, Aynsley-Green A, Ward Platt MP, Schwartz R, et al. Controversies regarding definition of neonatal hypoglycemia: suggested operational thresholds. 2000;105(5):1141–1145.
- World Health International statistical classification of diseases and related health problems, 10th revision. 2nd ed. Geneva: WHO; 2004.
- Quinn JA, Munoz FM, Gonik B, Frau L, Cutland C, Mallet-Moore T, et Preterm birth: case definition and guidelines for data collection, analysis, and presentation of immunisation safety data. Vaccine. 2016;34(49):6047–6056.
- Kramer Determinants of low birth weight: methodological assessment and meta-analysis. Bull World Health Organ. 1987;65(5):663–737.
- Zerbeto AB, Cortelo FM, Élio Filho Association between gestational age and birth weight on language development of Brazilian children: a systematic review. J Pediatr (Rio J). 2015;91(4):326–332.
- Sicuri E, Bardají A, Sigauque B, Maixenchs M, Nhacolo A, Nhalungo D, et al. Costs associated with low birth weight in a rural area of southern PLoS One. 2011;6(12):e28744.
- Sharma D, Shastri S, Sharma Intrauterine growth restriction: antenatal and postnatal aspects. Clin Med Insights Pediatr. 2016;10:67–83.