Hypoglycemia in preterm babies Incidence and risk factors

  • Asril Aminullah Department of Child Health, Medical School, University of Indonesia, Cipto Mangunkusumo Hospital, Jakarta
  • Dita Setiati Department of Child Health, Medical School, University of Indonesia, Cipto Mangunkusumo Hospital, Jakarta
  • Sudigdo Sastroasmoro Department of Child Health, Medical School, University of Indonesia, Cipto Mangunkusumo Hospital, Jakarta
Keywords: hypoglycemia, preterm babies, risk factors

Abstract

Hypoglycemia is one of the most common problems in neonates, especially in preterm babies. Although in the
majority of cases the outcome is good, symptomatic or asymptomatic hypoglycemia may give significant complications that
may cause death or developmental delay later in life. We conducted a cross sectional study from September 5, 1999 through
May 8, 2000 to identify factors associated with hypoglycemia in preterm babies treated at the Division of Perinatology, Cipto
Mangunkusumo Hospital, Jakarta. There were 112 babies included in the study, with the mean gestational age of 33.3 (range
22 to 37, SD 4.2) weeks, and mean birth weight of 1801 (range 850 to 2440, SD 420) grams. Twenty-seven of the 112 infants
showed hypoglycemia. Univariate analysis disclosed that birth weight, degree of perinatal asphyxia, small for gestational age
(SGA), presence of respiratory distress syndrome, mothers with preeclampsia or eclampsia, and mothers who had intravenous
infusion of glucose during labor were significantly associated with hypoglycemia in preterm babies. Gestational age,
meconium staining, or infant of diabetic mother were not significantly associated with neonatal hypoglycemia. On logistic
regression analysis to control confounders we found that only the degree of perinatal asphyxia and small for gestational age
were associated with hypoglycemia in those preterm babies.

References

1. Monintja HE. Beberapa aspek kebutuhan bayi kurang bulan. In: Suradi R, Monintja HE, Amalia P, Kusumowardhani D, editors. Penanganan mutakhir bayi prematur: memenuhi kebutuhan bayi prematur untuk
menunjang peningkatan kualitas sumber daya manusia. Naskah lengkap Pendidikan Kedokteran Berkelanjutan Ilmu Kesehatan Anak FKUI; 7-8 April 1997; Jakarta: Balai Penerbit FKUI,1997.p.11-43.
2. Cloherty JP, Pursley DWM. Identifying the high-risk newborn and evaluating gestational age, prematurity, postmaturity, large for gestational age, and small for gestational infants. In: Cloherty JP, Stark AR, editors. Manual of neonatal care. 4th ed. Philadelphia: Lippincott Williams &
Wilkins, 1998. p. 37-51.
3. Cornblath M, Hawdon JM, Williams AF, et al. Controversies regarding definition of neonatal hypoglycemia: suggested operational thresholds. Pediatrics 2000;105:1141-5.
4. World Health Organization. Hypoglycemia of the new born: review of the literature. Geneva, Switzerland: World Health Organization; 1997. Available at: htpp://www.who.int/chd/pub/imci/bf/hypoglyc/hypolyc.htm.
5. Aynsley-green A, Hawdon JM. Hypoglycemia in neonate: current controversies. Acta Paediatr Jpn 1997; 39, suppl 1:12-6.
6. Lubchenco L, Bard H. Incidence of hypoglycemia in newborn infants classified by birth weight and gestational age. Pediatrics 1971; 47(5):83-8.
7. Gutberlet RL, Cornblath M. Neonatal hypoglycemia revisited 1975. Pediatrics 1975; 58: 10-7.
8. Griffiths AD, Bryant GM. Assessment of effect of neonatal hypoglycemia. A study of 41 cases with matched controls. Arch Dis Child 1971; 46: 819.
9. Pildes RS, Pyati SP. Hypoglycemia and hyperglycemia in tiny infant clinics. Perinatology 1986; 13: 351-75.
10. Pildes RS, Cornblath M. A prospective controlled study of neonatal hypoglycemia. Pediatrics 1974; 54:14.
11. Siregar HS. Hipoglikemia pada bayi baru lahir. Medika 1988;9:839-45.
12. Ogata ES. Carbohydrate homeostasis. In: Avery GB, Fletcher MA, Mc Donald MG, editors. Neonatology pathophysiology and management of the newborn. 4th ed. Philadelphia: JB Lippincott, 1994. p. 568-84.
13. Retayasa W. Kejadian, manifestasi klinis, dan faktor-faktor risiko hipoglikemia pada BBLR di RSUP Sanglah, Denpasar. Tesis. Denpasar: Bagian Ilmu Kesehatan Anak FK UNUD, 1998.
14. Kalhan SC, Saker F. Metabolic and endocrine disorders. In: Fanaroff AA, Martin RJ, editors. Neonatal-perinatal medicine. Disease of the fetus and infant. 6th ed. St Louis: Mosby, 1997. p. 1439-61.
15. Collins JE, Leonard JV, Teale D, et al. Hyperinsulinemic hypoglycemia in small for dates babies. Arch Dis Child 1990; 1118-20.
16. Lteif AN, Schwenk WF. Hypoglycemia in infants and children. Endocrin Metab Clin North Am 1999;28:619-46.
17. Bolognese RJ, Schwarz RH, Schneider J. The gastrointestinal tract and perinatal metabolism. In: Bolognese RJ, Schwarz RH, Schneider J, editors. Perinatal medicine. 2nd ed . New York: Harper & Row, 1976. p. 253-6.
18. Snyder EY, Cloherty JP. Perinatal asphyxia. In: Cloherty JP, Stark AR, editors. Manual of neonatal care. 4th ed. Philadelphia: Williams & Wilkins, 1998. p. 568-84.
19. Cornblath M, Odel GB, Levin EY. Symptomatic neonatal hypoglycemia associated with toxemia of pregnancy. J Pediatr 1959;55:545-62.
20. Di Giacomo JE, Hay WW. Abnormal glucose homeostasis. In : Sinclair JC, editor. Effective care of the newborn infant. Oxford: Oxford University Press: 1976. p. 590-601.
21. Grylackj LJ, Chu SS, Scanlor JW. Use of IV fluid before caesarean section: effect on perinatal glucose, insulin, and sodium homeostasis. Obstet Gynecol 1984; 63:654-8.
Published
2001-04-30
How to Cite
1.
Aminullah A, Setiati D, Sastroasmoro S. Hypoglycemia in preterm babies Incidence and risk factors. PI [Internet]. 30Apr.2001 [cited 25Apr.2024];41(3-4):82-7. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/1243
Section
Articles
Received 2017-02-01
Accepted 2017-02-01
Published 2001-04-30