Hypoglycaemia in the Newborn

Abstract Aim: Severe neonatal hypoglycaemia (HG) leads to neurologic damage, mental retardation, epilepsy, impaired cardiac performance and muscle weakness. The aim was to assess the frequency and severity of HG in a population of newborns. Patients and methods: We investigated 739 patients with neonatal hypoglycaemia (HG) (M:F=370:369) born at the University Clinic for Gynaecology and Obstetritics in Skopje in the period 2014-2016 and treated at the neonatal intensive care unit (NICU). 1416 babies were treated in the same period in NICU, and HG was observed in 52.18%. The birth weight was dominated by children with low birth weight: very low birth weight (VLBW)(<1500g) 253 children, (34,23%), low birth weight (1500-2500g) 402 (54.39%), appropriate for gestational age (AGA) 78(10.55%), and high birth weight (>4000g) 6 babies (0.81%). The gestational age was also dominated by children with low gestational age: gestational week (GW) 20-25 four children (0.54%), 26-30 GW 133 babies (17.99%), 31-35 GW472 (63.87%), and 36-40 GW130 neonates (17.59 %). 241 mothers (32.61%) have had an infection during pregnancy, 82 preeclampsia or eclampsia (11.09%), 20 diabetes mellitus (2.70%), 78 placental situations (placenta previa, abruption) (10.55%). In this study 47 babies (6.35%) with HG and co-morbidities died. There was a significant positive correlation between HG birth weight (p<0.01), gestational age (p<0.05), and the lowest Apgar score (p<0.01). Neonatal deaths were significantly correlated with GA (р>0,01), co-morbidities of the mothers (р>0,05) but not with the birth weight (р>0,05). In contrast, a significant positive correlation was found between convulsions and body weight (р<0.05). The lowest Apgar score was positively correlated with the gestational age (0.01), but not with the birth weight (0.05). Conclusion: Low birth weight, low gestational age, maternal risk factors, hypoxic-ischemic encephalopathy and neonatal infections are associated with HG and are a significant factor in overall neonatal mortality. Those results indicate that diminishing the frequency of the neonatal HG and the rates of neonatal mortality requires complex interaction of prenatal and postnatal interventions.

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Hyperemesis Gravidarum and Obstetric Outcome

Nepal Journal of Obstetrics and Gynaecology ◽

10.3126/njog.v6i2.6752 ◽

2012 ◽

Vol 6 (2) ◽

pp. 24-26

Author(s):

A Giri ◽

AS Tuladhar ◽

H Tuladhar

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Hospital Stay ◽

Gestational Age ◽

Apgar Score ◽

Congenital Anomalies ◽

Hyperemesis Gravidarum ◽

Obstetric Outcomes ◽

Obstetric Outcome ◽

Perinatal Deaths

Aims: This study was conducted to evaluate maternal characteristics and obstetric outcomes among women with hyperemesis gravidarum during pregnancy. Methods: A prospective hospital based study was conducted at Nepal medical college and teaching hospital over the period of two years where all the women admitted with history of hyperemesis gravidarum were evaluated. Hyperemesis gravidarum was defined as intractable nausea/vomiting in pregnancy that leads to dehydration, nutritional deficiency, electrolyte and metabolic disturbances and considerable ketonuria that may require hospitalization. The age of women, parity, gestational age, method of treatment and duration of hospital stay were analysed.The fetal outcome evaluated were incidence of preterm birth, apgar score <7 at 5 mins of birth, low birth weight, perinatal deaths and congenital anomalies in baby. Results: There were 52 women admitted with hyperemesis gravidarum among all obstetric admission (N= 2080). The incidence of hyperemesis gravidarum was 2.5% of all pregnancy. The condition was seen more commonly in nulliparous (61.5%) than in multiparous women. It was less common in women of parity 3 or more. The problem was identified maximum (50%) in gestational age of 5-7 weeks though one case was seen in gestational age of 20 weeks also. The mainstay of treatment was supportive. The range of hospital stay was 1-10 days with mean hospital stay 2.26 days. The preterm delivery rate was 4.8% and none of the babies were low birth weight. All the babies had apgar score >7 at 5 mins of birth. There were no congenital anomalies and no perinatal deaths were noted. Conclusions: Women with hyperemesis gravidarum did not have adverse obstetric outcome in this study. NJOG 2011 Nov-Dec; 6 (2): 24-26 DOI: http://dx.doi.org/10.3126/njog.v6i2.6752

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Dengue during pregnancy and live birth outcomes: a cohort of linked data from Brazil

BMJ Open ◽

10.1136/bmjopen-2018-023529 ◽

2019 ◽

Vol 9 (7) ◽

pp. e023529 ◽

Cited By ~ 2

Author(s):

Enny S Paixão ◽

Oona M Campbell ◽

Maria Gloria Teixeira ◽

Maria CN Costa ◽

Katie Harron ◽

...

Keyword(s):

Birth Weight ◽

Preterm Birth ◽

Low Birth Weight ◽

Birth Outcomes ◽

Live Birth ◽

Gestational Age ◽

Small For Gestational Age ◽

Severe Dengue ◽

Maternal Risk ◽

Increased Risk

ObjectivesDengue is the most common viral mosquito-borne disease, and women of reproductive age who live in or travel to endemic areas are at risk. Little is known about the effects of dengue during pregnancy on birth outcomes. The objective of this study is to examine the effect of maternal dengue severity on live birth outcomes.Design and settingWe conducted a population-based cohort study using routinely collected Brazilian data from 2006 to 2012.ParticipatingWe linked birth registration records and dengue registration records to identify women with and without dengue during pregnancy. Using multinomial logistic regression and Firth method, we estimated risk and ORs for preterm birth (<37 weeks’ gestation), low birth weight (<2500 g) and small for gestational age (<10thcentile). We also investigated the effect of time between the onset of the disease and each outcome.ResultsWe included 16 738 000 live births. Dengue haemorrhagic fever was associated with preterm birth (OR=2.4; 95% CI 1.3 to 4.4) and low birth weight (OR=2.1; 95% CI 1.1 to 4.0), but there was no evidence of effect for small for gestational age (OR=2.1; 95% CI 0.4 to 12.2). The magnitude of the effects was higher in the acute disease period.ConclusionThis study showed an increased risk of adverse birth outcomes in women with severe dengue during pregnancy. Medical intervention to mitigate maternal risk during severe acute dengue episodes may improve outcomes for infants born to exposed mothers.

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Prevalence and risk factors associated with low birth weight babies-a cross sectional study

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20212466 ◽

2021 ◽

Vol 8 (7) ◽

pp. 1168

Author(s):

Gurunathan Gopal

Keyword(s):

Risk Factors ◽

Birth Weight ◽

Low Birth Weight ◽

Gestational Age ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Maternal Risk ◽

Factors Associated ◽

The World

Background: Babies with a birth weight of less than 2500 grams, irrespective of the period of their gestation are termed as low birth weight (LBW) babies. Despite consistent efforts to improve the quality of maternal and child health, more than twenty million LBW babies are born every year throughout the world. The present study was to explore the effects of various maternal risk factors associated with low birth-weight of institutionally delivered newborns. Across the world, neonatal mortality is 20 times more likely for LBW babies compared to normal birth weight (NBW) babies (>2.5 kg).Methods: A cross sectional study was conducted in neonatal intensive care unit (NICU) of ACS Medical College and Hospital, Chennai from December 2019 to October 2020. Altogether 350 babies were taken who were delivered at ACS hospital.Results: The number of times of ANC attendance was also significantly associated with LBW, odds ratio (OR)=1.296, and p=0.001. The number of meals was not associated with LBW OR=0.946, and p=0.831. The gestational age assessed as completed weeks of pregnancy was significantly associated with LBW OR=3.302; p=0.00001.Conclusions: This study suggests that there are several factors interplaying which lead to LBW babies. Socio-demographic factors (maternal age and gestational age) and antenatal care are more important.

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Effects of Hypertensive Disorders of Pregnancy On The Mortality and Complications in Very Low Birth Weight Neonates

10.21203/rs.3.rs-742435/v1 ◽

2021 ◽

Author(s):

Baoquan Zhang ◽

Xiujuan Chen ◽

Changyi Yang ◽

Huiying Shi ◽

Wenlong Xiu ◽

...

Keyword(s):

Mechanical Ventilation ◽

Risk Factor ◽

Birth Weight ◽

Low Birth Weight ◽

Gestational Age ◽

Apgar Score ◽

Very Low Birth Weight ◽

Fetal Distress ◽

Hypertensive Disorders Of Pregnancy ◽

Hypertensive Disorders

Abstract Purpose This study was designed to investigate the effects of hypertensive disorders of pregnancy (HDP) on the mortality and complications in very low birth weight neonates. Methods Premature infants at a gestational age of < 37 weeks with a birth weight of < 1,500g were included in this retrospective analysis. Gestational age-matched pregnant women with normal blood pressure giving birth to a very low birth weight neonate served as normal control. HDP neonates were divided into three subgroups based on the disease severity, including gestational hypertension, pre-eclampsia and eclampsia. Then we compared the incidence of complications among three subgroups. We also analyzed the relationship between the subgroups and the neonatal prognosis. Results The incidence of fetal distress, small for gestational age (SGA), mechanical ventilation, neonatal respiratory distress syndrome (RDS), neonatal necrotizing enterocolitis (NEC, ≥ 2 stage), and mortality in HDP group were significantly higher than those of the control. The 1 min Apgar score in HDP group was significantly lower than that of the normal control (P < 0.05). There were significant differences in fetal distress, 1 min Apgar score, mechanical ventilation, RDS and NEC (≥ 2 stage) among HDP, pre-eclampsia and eclampsia subgroups (P < 0.05). Multivariate regression analysis indicated that pre-eclampsia was an independent risk factor for SGA (OR = 4.123, 95%CI: 2.783–6.109) and NEC (OR = 2.493, 95%CI: 1.161–5.351). Eclampsia was a risk factor for SGA (OR = 3.804, 95%CI: 1.239–11.681) and NEC (OR = 7.264, 95%CI: 1.771–29.797). Conclusions HDP may affect the prognosis of very low birth weight neonates. Pre-eclampsia and eclampsia were risk factors for SGA and NEC.

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Clinical Profile of Neonatal Hypoglycaemia in a Tertiary Care Centre in Mahabubnagar, Telangana

Journal of Evidence Based Medicine and Healthcare ◽

10.18410/jebmh/2021/589 ◽

2021 ◽

Vol 8 (35) ◽

pp. 3241-3246

Author(s):

Nagaveni Patta ◽

Manthena Jagadeesh Kumar ◽

Mohd Sirazuddin

Keyword(s):

Intensive Care ◽

Blood Glucose ◽

Birth Weight ◽

Low Birth Weight ◽

Gestational Age ◽

Neonatal Intensive Care ◽

Glucose Monitoring ◽

Neonatal Intensive Care Units ◽

Neonatal Hypoglycaemia ◽

Time Of Admission

BACKGROUND Hypoglycaemia is one of the most common metabolic problems seen in neonatal intensive care units (NICU). Most cases of neonatal hypoglycaemia are transient and respond readily to treatment and are associated with excellent prognosis. Development of clinical signs and symptoms may be a late sign of hypoglycaemia. Persistent hypoglycaemia may result in possible neurologic sequelae. The purpose of this study was to assess the clinical pattern of hypoglycaemia in neonates admitted in special newborn care unit in Government General hospital, Mahabubnagar, Telangana and to also assess the influence of gestational age, birth weight, various comorbid conditions on blood glucose levels. METHODS This is an observational hospital-based study done in Government General Hospital, Mahabubnagar from June 2020 to May 2021. Neonates with hypoglycaemia (blood glucose < 45 mg/dl) at the time of admission are included in our study. Blood glucose values were monitored 2nd hourly on 1st day and 6th hourly thereafter. Following the detection of hypoglycaemia, the neonates were treated as per institutional protocol. Clinical features, laboratory parameters are studied and analysed. RESULTS Among the 99 neonates studied, 68 (68.7 %) were males and 31 (31.3 %) females; Term babies were 75 (75.7 %) and pre term babies were 24 (24.2 %). Low birth weight newborns (51.5 %) were more affected with hypoglycaemia compared to normal weight newborns (38.4 %). Among the 99 neonates studied, 96.9 % were treated and discharged. Average duration of stay was around 05 to 07 days. CONCLUSIONS Hypoglycaemia is most common condition in neonates. Routine screening should be done to all newborns at the time of admission. Timely intervention reduces long term neurological sequelae. Neonates presenting with dull activity, refusal to feed, vomiting, jitteriness, seizures must routinely undergo regular glucose monitoring. As the study shows, most hypoglycaemic neonates presented with those symptoms. Among the various comorbidities, hypoglycaemia occurred more in birth asphyxia and respiratory distress syndrome. So, it should be made mandatory to do glucose monitoring in these cases. Glucose monitoring should be made as a common screening method to prevent morbidity and mortality in neonatal intensive care units. KEYWORDS Hypoglycaemia, Pre-Term, Term, Low Birth Weight, Special New Born Care Unit, Small for Gestational Age, Large for Gestational Age

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NEONATAL HYPOGLYCEMIA

The Professional Medical Journal ◽

10.29309/tpmj/2014.21.04.2312 ◽

2018 ◽

Vol 21 (04) ◽

pp. 745-749

Author(s):

Sikandar Ali Bhand ◽

Farzana Sheikh ◽

Abdul Rehman Siyal ◽

Muhammad Akber Nizamani ◽

Muhammad Saeed

Keyword(s):

Risk Factors ◽

Birth Weight ◽

Family History ◽

Low Birth Weight ◽

Gestational Age ◽

Metabolic Disorder ◽

Maternal Risk Factors ◽

Diabetic Mellitus ◽

Maternal Risk ◽

History Of

… Objective: To determine the presenting features and assessment of the neonateswith hypoglycemia along with maternal and neonatal risk factors for hypoglycemia. Subjects &methods: All consecutive neonates with hypoglycemia admitted were included in the study.Demographic characteristics of the mothers and their babies, past medical history and illnessesduring pregnancy especially that, of diabetes mellitus and duration, details of the management oflabour and place of delivery, birth asphyxia as well as history of feeding prior to admission. All therisk factors and clinical features were documented. Results: From presenting features neonateswere most common temperature instability 32% of the neonates. Maternal risk factors were asMaternal diabetic mellitus, Intrapartum administration of glucose , Maternal drug uses as: (Betablockers, Oral hypoglycemic agents, Valproate), family history of metabolic disorder and withoutany factors with the percentage 13%, 17%, (15%, 08%, 07%) , 27% and 13% respectively.Neonatal risk factors of the patients were found low birth weight 49%, small gestational age 26%,macrosomia 11%, respiratory distress 32%, sepsis 20%, hypothermia 25%, congenital cardiacabnormalities 4%, endocrine disorder 4%, family history of metabolic disorder 7%, inborn errorsof metabolism 4%, rhesus hemolytic disease 5%, erythroblastosis fetalis 1%, inadequate feeding35% and neonates without factors were 6%. Conclusions: The risk factors associate withneonatal hypoglycemia are, low birth weight, small gestational age, macrodome, respiratorydistress, sepsis, hypothermia and inadequate feeding , and maternal risk factors associate toneonatal hypoglycemia was Eclampsia, Maternal diabetic mellitus, and maternal drug uses

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CLINICAL RISK INDEX FOR BABIES (CRIB SCORE) AS A PREDICTOR OF NEONATAL MORTALITY

Journal of University Medical & Dental College ◽

10.37723/jumdc.v10i4.70 ◽

2019 ◽

Vol 10 (4) ◽

pp. 5-10

Author(s):

Zarmast Khan ◽

Nasir Zulﬁqar ◽

Hamid Mahmood et al.

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Neonatal Mortality ◽

Gestational Age ◽

Very Low Birth Weight ◽

Risk Index ◽

Preterm Neonates ◽

Cross Sectional ◽

Study Population ◽

Crib Score

ABSTRACT:OBJECTIVE: It is very important to predict the outcome among preterm and very low birth weight babies as mortality rates are quite high. CRIB score is used to predict the outcomes in preterm neonates. The objective of this study was to determine the strength of CRIB score in detecting neonatal mortality in babies presenting with very low birth weight. STUDY DESIGN: Cross-sectional study. SUBJECTS: A total of 254 newborns with birth weight of between 500 to 1500 grams and gestational age of ≤35 weeks were included. The study was conducted over a period of 6 months in neonatology department of Shifa International Hospital, Islamabad. METHODS: CRIB score was obtained through a prospective way in all neonates and its association was assessed with mortality during neonatal intensive care unit (NICU) stay. RESULTS: The percentage of male and female newborn subjects was 54.3% (n=138) and 45.7% (n=116) respectively. Mean gestational age was 33.3 weeks ± 1.04 and mean birth weight of study population was 1129.9 grams ± 210.6. Mean CRIB score among the study population was 6.3 ± 3.1 and overall mortality was found to be 54.7% (n=139). Mean CRIB score was found to be 8.27 ± 2.1 among mortality group and it was 3.87 ± 3.4 among newborns who were discharged (P<0.05). Mortality was present in 4.3% (n=4) of neonates with CRIB score between 1-5, 87.1% (n=121) who had CRIB score between 6-10 and 100% (n=14) of neonates who had CRIB score between 1115 (P<0.05). CONCLUSION: Signiﬁcantly higher mortality was noted among neonates with higher CRIB scores.

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Sex, Conception Interval, Gestational Age, Apgar Score, and Anthropometric Surrogates in relation to Birth Weight of Bangladeshi Newborns: A Cross-Sectional Study

ISRN Public Health ◽

10.1155/2013/405725 ◽

2013 ◽

Vol 2013 ◽

pp. 1-8 ◽

Cited By ~ 2

Author(s):

Bably Sabina Azhar ◽

Md. Monirujjaman ◽

Kazi Saiful Islam ◽

Sadia Afrin ◽

Md. Sabir Hossain

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Gestational Age ◽

Apgar Score ◽

Rural Areas ◽

Weight Status ◽

Cross Sectional Study ◽

Anthropometric Parameters ◽

Cross Sectional ◽

Infant Birth

In developing countries, where about 75% of births occur at home or in the community, logistic problems prevent the weighing of every newborn child. Baby born with a weight less than 2,500 g is considered low birth weight, since below this value birth-specific infant mortality begins to rise rapidly. In Bangladesh, the prevalence of low birth weight is unacceptably high. Infant's sex differences, birth to conception interval, gestational age, and Apgar score are associated with infant birth weight. To screen low-birth-weight babies, simple anthropometric parameters can be used in rural areas where 80–90% of deliveries take place. A sample of 343 newborn singletons, 186 male and 157 female babies, were studied in Southwest region of Bangladesh to examine the birth weight status of newborns and to identify the relationship between birth weight and other anthropometric parameters of newborns. The mean birth weight was 2754.81±465.57 g, and 28.6% were low-birth-weight (<2,500 g) babies. All key anthropometric parameters of the newborns significantly correlated with infant birth weight (P=0.05). Mid upper arm circumference and chest circumference were identified as the optimal surrogate indicators of LBW babies. In the community where weighing of newborns is difficult, these measurements can be used to identify the LBW babies.

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Pregnancy-associated cancers and birth outcomes in children: a Danish and Swedish population-based register study

BMJ Open ◽

10.1136/bmjopen-2018-022946 ◽

2018 ◽

Vol 8 (12) ◽

pp. e022946 ◽

Cited By ~ 2

Author(s):

Natalie C Momen ◽

Linn Håkonsen Arendt ◽

Andreas Ernst ◽

Jørn Olsen ◽

Jiong Li ◽

...

Keyword(s):

Logistic Regression ◽

Birth Weight ◽

Caesarean Section ◽

Low Birth Weight ◽

Birth Outcomes ◽

Gestational Age ◽

Apgar Score ◽

Population Based ◽

Adverse Birth Outcomes

ObjectivesThis study aims to estimate the association between pregnancy-associated maternal cancers, diagnosed both prenatally and postnatally, and birth outcomes.DesignPopulation-based register study.SettingNational registers of Denmark and Sweden.ParticipantsA total of 5 523 365 children born in Denmark (1977–2008) and Sweden (1973–2006).Primary and secondary outcome measures: gestational age, birth weight, size for gestational age, Apgar score, caesarean section and sex were the outcomes of interest. ORs and relative risk ratios (RRR) with 95% CIs were estimated using logistic regression and multinomial logistic regression, respectively.ResultsIn this study, 2% of children were born to mothers with a diagnosis of cancer. Children whose mothers received a prenatal cancer diagnosis had higher risk of being born preterm (RRR: 1.77, 95% CI 1.64 to 1.90); low birth weight (RRR 1.84, 95% CI 1.69 to 2.01); low Apgar score (OR 1.36, 95% CI 1.20 to 1.56); and by caesarean section (OR: 1.69, 95% CI 1.59 to 1.80). Associations moved towards the null for analyses using postnatal diagnoses, but preterm birth (RRR: 1.13, 95% CI 1.09 to 1.17) and low birth weight (RRR: 1.14, 95% CI 1.09 to 1.18) remained statistically significant, while risk of caesarean section became so (OR: 0.95, 95% CI 0.91 to 0.98). Additionally, statistical significance was reached for large for gestational age (RRR: 1.06, 95% CI 1.01 to 1.11), high birth weight (RRR: 1.04, 95% CI 1.01 to 1.06) and caesarean section (OR: 0.95, 95% CI 0.91 to 0.98).ConclusionsResults suggest an association between pregnancy-associated cancers and adverse birth outcomes in the offspring. While this is strongest for prenatally diagnosed cancers, some smaller associations exist for postnatally diagnosed cancers, indicating that cancer itself could affect fetal development, or that cancer and adverse birth outcomes share risk factors. Future studies on maternal cancer during pregnancy should consider including some postnatal years in their exposure window.

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