నైరూప్య

Study of risk factors and outcome of hypoglycemia in neonates admitted in NICU of a tertiary care hospital in central India.

Dipak Madavi, Manojkumar L Joshi, Milind Suryawanshi, Bhagyashree Tirpude, Lakshmikant R*ohadkar

Background: Neonatal hypoglycemia is a common metabolic disturbance observed during neonatal period. It may be transient asymptomatic event normally occurring as a result of extrauterine adaptation of newborn without any ill effect on somatic or neuronal growth newborn. Objectives: To determine risk factors and outcome of hypoglycaemia in neonates. Methods: It was a prospective observational study conducted between December 2020 to November 2022 in the Indira Gandhi Govt. Medical College, Nagpur in Central India. Study population included neonates admitted in Neonatal Intensive Care Unit (NICU) with hypoglycaemia or who had hypoglycaemia during NICU stay. The study was approved by the Institutional Ethical Committee. All the data was entered in excel sheet and results were expressed in terms of number and percentage. Results: 150 neonates with neonatal hypoglycemia satisfying the inclusion and exclusion criteria were enrolled after written informed consent of guardian of the baby. Among 150 hypoglycaemic neonates, number of males 88 (58.67%) was more than females 62 (41.33%). Neonatal risk factors maximum number of babies had septicemia 51 (34%) followed by Respiratory Distress Syndrome (RDS) in 46 (30.67%) babies, Birth asphyxia in 17 (11.33%), meningitis in 11 (7.33%) and twin gestation 9 (6%) in babies with neonatal hypoglycemia. No neonatal risk factor was found in 61 (40.66%) neonates with hypoglycemia. Maternal risk factors Pregnancy Induced Hypertension (PIH) was found in 40 (26.67%) neonates, Prolonged Rupture of Membranes (PROM) in 36 (24%) neonates, Infant of Diabetic Mother (IDM) in 21(14%) neonates, Antepartum Haemorrhage (APH) in 10 (6.67%) neonates. No maternal risk factor was found in 54 (36%) neonates with neonatal hypoglycemia. Majority of discharged babies 123 (93.89%) had normal neurological status and 8 (6.1%) had abnormal neurological status at the time of discharge. Out of 150 hypoglycemic neonates 19 died and mortality was 12.67%. Conclusion: Present study found prevalence of neonatal hypoglycemia was 17.79%. PIH was found to be the most common maternal risk factor and neonatal septicemia was the most common neonatal risk factor. Most of the babies with hypoglycemia were symptomatic and lethargy was the most common clinical presentation at the time of hypoglycemia. Majority of neonates were discharged with normal neurological status.