出生体重低于第10百分位数的足月儿低血糖症。
Hypoglycemia in term newborns with a birth weight below the 10th percentile.
作者信息
Mejri Abdelwaheb, Dorval Veronique G, Nuyt Anne Monique, Carceller Ana
机构信息
Department of Pediatrics, CHU Sainte-Justine, 3175 Côte Sainte-Catherine, Montreal, Quebec.
出版信息
Paediatr Child Health. 2010 May;15(5):271-5. doi: 10.1093/pch/15.5.271.
BACKGROUND
Current recommendations suggest that routine screening for hypoglycemia should be performed in all term newborns with a birth weight (BW) below the 10th percentile. The impact of updated growth curves on the incidence of hypoglycemia in small-for-gestational-age (SGA) newborns has not been evaluated.
OBJECTIVES
To evaluate the occurrence and severity of hypoglycemia in term newborns with a BW between the 10th and fifth percentile, and below the fifth percentile, using recently updated growth curves.
DESIGN
A one-year prospective cohort study.
METHODS
Inclusion criteria were gestational age of 37 weeks or greater and BW below the 10th percentile. Neonatal hypoglycemia was defined as a blood glucose level of less than 2.6 mmol/L measured after 2 h of life. Blood glucose was measured routinely for all SGA infants during the first 36 h of life.
RESULTS
A total of 187 SGA infants met the study criteria: 85 infants with a BW between the 10th and fifth percentile, and 102 infants with a BW below the fifth percentile. The characteristics of the study cohort were similar between BW groups. Twenty-six per cent of the infants screened had at least one episode of hypoglycemia: 22% of infants in the 10th to fifth percentile group and 28% in the less than fifth percentile group. Hypoglycemia was symptomatic in four infants, all of whom were below the fifth percentile for BW. The mean (± SD) lowest blood glucose level was 2.1±0.4 mmol/L (range 0.6 mmol/L to 2.5 mmol/L) in the 10th to fifth percentile group and 2.0±0.5 mmol/L (range 0.8 mmol/L to 2.5 mmol/L) in the less than fifth percentile group (P=0.05).
CONCLUSION
The present study demonstrates a high incidence of hypoglycemia among SGA infants with a BW below the 10th percentile using updated growth curves. There was no difference in the incidence of hypoglycemia among SGA infants with a BW below the fifth percentile versus those with a BW between the 10th and fifth percentile.
背景
目前的建议表明，应对所有出生体重（BW）低于第10百分位数的足月儿进行低血糖常规筛查。尚未评估更新后的生长曲线对小于胎龄（SGA）新生儿低血糖发生率的影响。
目的
使用最近更新的生长曲线，评估出生体重在第10百分位数与第5百分位数之间以及低于第5百分位数的足月儿低血糖的发生情况和严重程度。
设计
一项为期一年的前瞻性队列研究。
方法
纳入标准为胎龄37周或以上且出生体重低于第10百分位数。新生儿低血糖定义为出生后2小时测量的血糖水平低于2.6 mmol/L。在出生后的前36小时内，对所有小于胎龄儿常规测量血糖。
结果
共有187例小于胎龄儿符合研究标准：85例出生体重在第10百分位数与第5百分位数之间，102例出生体重低于第5百分位数。出生体重组之间的研究队列特征相似。筛查的婴儿中有26%至少有一次低血糖发作：第10至第5百分位数组中的婴儿为22%，低于第5百分位数组中的婴儿为28%。4例婴儿出现症状性低血糖，所有这些婴儿的出生体重均低于第5百分位数。第10至第5百分位数组中最低血糖水平的平均值（±标准差）为2.1±0.4 mmol/L（范围0.6 mmol/L至2.5 mmol/L），低于第5百分位数组为2.0±0.5 mmol/L（范围0.8 mmol/L至2.5 mmol/L）（P = 0.05）。
结论
本研究表明，使用更新后的生长曲线，出生体重低于第10百分位数的小于胎龄儿低血糖发生率较高。出生体重低于第5百分位数的小于胎龄儿与出生体重在第10百分位数与第5百分位数之间的小于胎龄儿低血糖发生率无差异。
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