Neonatal hypoglycemia in children with risk factors

Objective: The analysis of clinical-laboratory peculiarities and the dynamics of glycemia clarifying the terms of blood glucose stabilization during the early neonatal period in children having risk factors of the development of such state.

Methods: Open, retrospective , continuous, single-center study was conducted. It was aimed at getting preliminary data that is important for planning further tactics of examining newborns having risk factors on hypoglycemia development (kids having large body weight at birth, children whose mothers have diabetes, newborns having intrauterine growth retardation).The target group of the survey included 522 newborns of both genders in the early neonatal period (from 0 to 7 days of life).

Results: There is data on the frequency of first indicated hypoglycemia in newborns having risk factors of the development of such state, clinicallaboratory peculiarities, the dynamics of glycemia during early neonatal period, and also the period of blood glucose stabilization (the age of reaching normoglycemia). Neonatal hypoglycemia was detected in 40.2% of examined children. Laboratory manifestation during the first day of life was noticed 62.9% of cases with the further normalization of glucose level in blood in 24 hours in 73.3% of newborns. Significant reduction of blood glucose was observed in 54.8% of cases requiring hypoglycemia therapy with parenteral prescription of 10% glucose solution. Hypoglycemia jugulated against oral correction of 5% glucoses solution in 40.5 % of cases. 4.8% of children got the level of glucose stabilized after introduction of supplementary feeding.

Conclusion: The results of the newborns having risk factors on hypoglycemia development (kids having large body weight at birth, children whose mothers have diabetes, newborns having intrauterine growth retardation) examinations are presented. The peculiarities of neonatal hypoglycemia are: the absence of a typical clinical symptoms among 89% of children. Asymptomatic course of hypoglycemia confirms the importance and necessity of glycemia monitoring in the early neonatal period in order to conduct timely and adequate therapy.

1. Chandran S., Rajadurai V.S., Alim A., Haium A., Hussain K. Current perspectives on neonatal hypoglycemia, its management, and cerebral injury risk. Journals Research and Reports in Neonatology. 2015;5:17-30. doi: 10.2147/RRN.S55353

2. Taranushenko T.E., Kiseleva N.G., Lazareva O.V., Kalyuzhnaya I.I. Hypoglycemia in newborns: literature review and case report. Endocrinology problems. 2019;65:(4):251-262 (In Russ). doi: 10.14341/probl8336.

3. Ivanov D.O. Glucose metabolism disorders in newborns. SPb.: Publishing house NL, 2011;64 (In Russ).

4. Safina A.I., Rybkina N.L. Transient hypoglycemia of newborns: etiology, diagnostic criteria, prevention and correction tactics in the early neonatal period. Practical medicine. 2011;53:(5):51-54 (In Russ).

5. Volodin N.N. Neonatology: a national guide. Short edition. M.: GEOTAR-Media, 2019;896 (In Russ).

6. Ayoub N.I., Hanoudi B.M., Naif M. Evaluation of Maternal and Neonatal Risk factors for Neonatal Hypoglycemia. Iraqi J. Comm. Med. 2013;1:13-18.

7. Kellams A., Harrel C., Omage S, Gregory C, Rosen-Carole C. ABM Clinical Protocol N3: Supplementary Feedings in the Healthy Term Breastfed Neonate, Revised 2017. Breastfeed Med. 2017;12:188-198. doi: 10.1089/bfm.2017.29038.ajk.

8. Postnatal Glucose Homeostasis in Late-Preterm and Term Infants. Pediatrics. Pediatrics. 2011;127:(3): 575-579. doi: 10.1542/peds.2010-3851.

9. Nagaeva E.V., Shiryaeva T. Yu. «Intrauterine programming» of hormonal and metabolic processes and intrauterine growth retardation syndrome. Endocrinology problems. 2010;56:(6):32-40 (In Russ).