Sasidharan C K, Gokul E, Sabitha S
Division of Neonatology, Department of Paediatrics, Institute of Maternal and Child Health, Medical College, Kozhikode, India.
Ceylon Med J. 2004 Dec;49(4):110-3. doi: 10.4038/cmj.v49i4.1919.
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 h of life.
Hospital based prospective study in a maternity centre in south India.
Labour room, postnatal wards and newborn nursery of the Institute of Maternal and Child Health, Medical College, Kozhikode, India.
Six hundred and four neonates were enrolled in the study by a systematic random sampling method from 1 August to 1 November 2002. INTERVENTION/MEASUREMENT: Random blood glucose levels were estimated by the standard glucose oxidase--peroxidase method on two occasions 24 h 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.
The incidence of neonatal hypoglycaemia in the present study group 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 breastfeeding for more than 2 h postnatally, maternal pre-eclampsia and eclampsia, birth asphyxia, cold stress or hypothermia, and maternal oligohydramnios.
Hypoglycaemia was a common problem in apparently normal asymptomatic babies. Apart from the classic 'text book risk factors', maternal oligohydramnios and a breastfeeding delay of more than 2 h 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.
检测预测新生儿低血糖发生的发病率及危险因素，并识别出生后48小时内需进行强制性血糖筛查的新生儿。
在印度南部一家妇产中心开展的基于医院的前瞻性研究。
印度科泽科德医学院母婴健康研究所的产房、产后病房及新生儿保育室。
2002年8月1日至11月1日，通过系统随机抽样方法选取604例新生儿纳入研究。
干预措施/测量方法：在出生后头两天，每隔24小时用标准葡萄糖氧化酶-过氧化物酶法测定随机血糖水平。对母婴对的19项临床特征与低血糖的发生情况进行统计学分析。
本研究组新生儿低血糖的发病率为41/1000活产儿。八个变量强烈且独立地预测了新生儿低血糖的风险，至少一个变量出现在89.1%的低血糖新生儿中。这些变量包括早产、低出生体重、母亲糖尿病、产后母乳喂养开始延迟超过2小时、母亲先兆子痫和子痫、出生窒息、冷应激或体温过低以及母亲羊水过少。
低血糖在看似正常无症状的婴儿中是一个常见问题。除了经典的“教科书式危险因素”外，母亲羊水过少和产后母乳喂养延迟超过2小时可预测该组新生儿低血糖的风险。对具有上述任何一种危险因素的婴儿进行强制性血糖筛查是及时识别这种情况的一种简单且经济有效的措施。
