Hypoglycemia Incidence in Newborns Identified to Be at Risk, Data from a Tertiary Care Hospital in Turkey
Abstract
Background: Neonatal hypoglycemia (NH) is one of the most prevalent neonatal problems. We aimed to describe frequency and patterns of NH in neonates at risk of hypoglycemia.
Methods: In this single-center retrospective descriptive cross-sectional study, the incidence of hypoglycemia in newborns at risk of NH born at Mersin University Hospital between Jan 2017 and Jan 2023, was investigated. The blood glucose level being lower than 40 mg/dL was defined as NH.
Results: Overall, 506 neonates at risk of hypoglycemia were included: 53 SGA infants (10.5%), 127 LGA infants (25.1%), 212 infants of diabetic mothers (41.9%), and 230 late preterm infants (45.5%). Hypoglycemia developed in 113 out of 506 at-risk newborns (22.3%). Symptomatic hypoglycemia developed in nine infants (1.8%), while asymptomatic hypoglycemia developed in 104 infants (20.5%). Recurrent hypoglycemia incidence was 4.2%. Severe hypoglycemia developed in 13 infants (2.6%). All symptomatic hypoglycemic infants and 8 asymptomatic hypoglycemic infants requiring IV glucose, 17 infants (17/506, 3.4%), were hospitalized in the NICU. The targeted blood glucose level was reached in 1 hour at the latest in all hypoglycemic infants.
Conclusion: With the algorithm applied, we did not see recurrent hypoglycemia after the first day of life in risky newborns, and we reached the targeted glucose values in hypoglycemic newborns within the desired period.
2. De Rose DU, Perri A, Maggio L, et al (2024). Neonatal hypoglycemia and neu-rodevelopmental outcomes: Yesterday, today, tomorrow. Eur J Pediatr, 183(3):1113-1119.
3. Edwards T, Harding JE (2021). Clinical As-pects of Neonatal Hypoglycemia: A Mini Review. Front Pediatr, 8:562251.
4. Wu T, Huang YY, Song W, et al (2023). De-velopment of a prediction model for neonatal hypoglycemia risk factors: a retrospective study. Front Endocrinol (Lau-sanne), 14:1199628.
5. Luo K, Tang J, Zhang M, He Y (2024). Sys-tematic review of guidelines on neonatal hypoglycemia. Clin Endocrinol (Oxf), 100(1):36-49.
6. Committee on Fetus and Newborn; Adam-kin DH (2011). Postnatal glucose home-ostasis in late-preterm and term infants. Pediatrics, 127(3):575-9.
7. Aliefendioğlu D, Çoban A, Hatipoğlu N, et al (2018). Approach to hypoglyce-mia in the newborn: Turkish Neonatal and Pediatric Endocrinology and Di-abetes Societies consensus report. Turk Pediatri Ars, 53(Suppl 1):S224-S233.
8. Harding JE, Alsweiler JM, Edwards TE, McKinlay CJ (2024). Neonatal hypo-glycaemia. BMJ Med, 3(1):e000544.
9. Jonas D, Dietz W, Simma B (2014). Hypo-glycemia in newborn infants at risk. Klin Padiatr, 226(5):287-91.
10. Stark J, Simma B, Blassnig-Ezeh A (2020). Incidence of hypoglycemia in newborn infants identified as at risk. J Matern Fetal Neonatal Med, 33(18):3091- 3096.
11. ElHassan NO, Schaefer EW, Gonzalez B, et al (2023). Early Transient Hypoglyce-mia and Test Performance in At-Risk Newborns. Am J Perinatol, 40(10):1096-1105.
12. Hosagasi NH, Aydin M, Zenciroglu A, et al (2018). Incidence of hypoglycemia in newborns at risk and an audit of the 2011 American academy of pediatrics guideline for hypoglycemia. Pediatr Neo-natol, 59(4):368-374.
13. Harris DL, Weston PJ, Harding JE (2012). Incidence of neonatal hypoglycemia in babies identified as at risk. J Pediatr, 161(5):787-91.
14. Roeper M, Hoermann H, Kummer S, et al (2023). Neonatal hypoglycemia: lack of evidence for a safe management. Front Endocrinol (Lausanne), 14:1179102.
15. Arimitsu T, Kasuga Y, Ikenoue S, et al (2023). Risk factors of neonatal hypogly-cemia in neonates born to mothers with gestational diabetes. Endocr J, 70(5):511-7.
16. Cioccale A, Brener Dik P, Galletti MF, et al (2022). Neonatal hypoglycemia in in-fants born to mothers with gestational diabetes mellitus. Comparison of its in-cidence based on maternal treatment. Arch Argent Pediatr, 120(4):232-9.
17. Irahara M, Nagai T, Takeuchi S, et al (2023). Association between early-term birth and hypoglycaemia in large-for-gestational-age neonates: A retrospective cohort study. J Med Invest, 70(3.4):476-82.
18. Schaefer-Graf UM, Rossi R, Bührer C, et al (2002). Rate and risk factors of hypogly-cemia in large-forgestational-age new-born infants of nondiabetic mothers. Am J Obstet Gynecol, 187(4):913-7.
19. Wang LY, Wang LY, Wang YL, et al (2023). Early neonatal hypoglycemia in term and late preterm small for gestational age newborns. Pediatr Neonatol, 64(5):538-546.
20. Costa LP, Costa GAM, Valete COS, et al (2022). In-hospital outcomes in preterm and small-for-gestational-age newborns: a cohort study. Einstein (Sao Paulo), 20:eAO6781.
21. Sharma D, Padmavathi IV, Tabatabaii SA, et al (2021). Late preterm: a new high risk group in neonatology. J Matern Fetal Neonatal Med, 34(16):2717-30.
22. Blank C, van Dillen J, Hogeveen M (2018). Primum non nocere: earlier cessation of glucose monitoring is possible. Primum non nocere: earlier cessation of glucose monitoring is possible. Eur J Pediatr, 177(8):1239-1245.
23. Zhou W, Yu J, Wu Y, et al (2015). Hypogly-cemia Incidence and Risk Factors As-sessment in Hospitalized Neonates. J Matern Fetal Neonatal Med, 28(4):422-5.
24. Bülbül A, Bahar S, Uslu S, et al (2019). Risk Factor Assessment and the Incidence of Neonatal Hypoglycemia in the Postnatal Period. Sisli Etfal Hastan Tip Bul, 53(4):389-394.
25. Singh P, Upadhyay A, Sreenivas V, et al (2017). Screening for Hypoglycemia in Exclusively Breastfed High-risk Neo-nates. Indian Pediatr, 54(6):477-480.
26. Cummings CT, Ritter V, LeBlanc S, et al (2022). Evaluation of Risk Factors and Approach to Screening for Asympto-matic Neonatal Hypoglycemia. Neonatol-ogy, 119(1):77-83.
27. O'Brien M, Gilchrist C, Sadler L, et al (2023). Infants Eligible for Neonatal Hypoglycemia Screening: A Systematic Review. JAMA Pediatr, 177(11):1187-96.
28. Thornton PS, Stanley CA, De Leon DD, et al (2015). Recommendations from the pediatric endocrine society for evalua-tion and management of persistent hy-poglycemia in neonates, infants, and children. J Pediatr, 167(2):238-45.
Files | ||
Issue | Vol 54 No 4 (2025) | |
Section | Original Article(s) | |
Keywords | ||
Hypoglycemia Newborns Screening |
Rights and permissions | |
![]() |
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |