A Study on Incidence and Risk factors for Neonatal Hypoglycaemia in a Tertiary Care Centre in Eastern Bihar.

Dr. Vimal Kumar; Dr. Brajesh Kumar

Volume : X, Issue : II, February - 2020

A Study on Incidence and Risk factors for Neonatal Hypoglycaemia in a Tertiary Care Centre in Eastern Bihar.

Dr. Vimal Kumar, Dr. Brajesh Kumar

Abstract :

INTRODUCTION: Neonatal hypoglycaemia is more common in a developing country like India .Neonatal hypoglycemia adversely affects the neurodevelopmental outcome, overall IQ, reading ability, arithmetic proficiency, and motor performance. OBJECTIVES: To detect the incidence and risk factors that predicted the occurrence of neonatal hypoglycaemia and to identify neonates who require mandatory blood glucose screening during the first 48 hours of life in a tertiary care centre in Eastern Bihar. METHODS: This study was conducted in the department of Pediatrics and Maternity centre of Jawahar Lal Nehru Medical College and Hospital, Bhagalpur, Bihar from December 2017 to November 2019 which is a Hospital based prospective study. Setting of the study was Labour room, postnatal wards and newborn nursery. Twelve hundred and eight neonates were enrolled in the study by a systematic random sampling method. Random blood glucose levels were estimated by the standard glucose oxidase– peroxidase method on two occasions 24 hours apart, during the first 2 days of life. Nineteen clinical characteristics of the mother–baby pair were analysed statistically in relation to the occurrence of hypoglycaemia. RESULTS: In the present study group the incidence of neonatal hypoglycaemia was 41/1000 live births. Eight variables strongly and independently predicted the risk of neonatal hypoglycaemia, at least one being present in 89.1% of the hypoglycaemic neonates. They included prematurity, low birthweight, maternal diabetes mellitus, delay in initiation of eastfeeding for more than 2 hour postnatally, maternal pre–eclampsia and eclampsia, birth asphyxia, cold stress or hypothermia, and maternal oligohydramnios. CONCLUSION: Hypoglycaemia was a common problem in apparently normal asymptomatic babies. Apart from the classic ‘text book risk factors’, maternal oligohydramnios and a eastfeeding delay of more than 2 hour after delivery predicted the risk of neonatal hypoglycaemia in this group. Mandatory blood glucose screening in babies with any one of the above mentioned risk factors serves as an easy and cost effective measure for the prompt identification of this condition by which morbidity and mortality assosciated with disease can be ought down.