Neonatal Netw. 2020 Aug 1;39(5):263-267. doi: 10.1891/0730-0832.39.5.263.
The incidence of hypoglycemia in the immediate postnatal period is rising because of the increasing rate of preterm births, maternal diabetes, and maternal obesity. Severe hypoglycemia has been considered a risk factor for neuronal cell death and adverse neurodevelopmental outcomes. The American Academy of Pediatrics (AAP) suggests a goal of ≥45 mg/dL (≥2.5 mmol/L) for infants who are asymptomatic within the first 48 hours. The Pediatric Endocrine Society (PES) suggests that infants who are unable to maintain their blood glucose >50 mg/dL (>2.77 mmol/L) within the first 48 hours or >60 mg/dL (>3.33 mmol/L) after the first 48 hours are at risk for persistent hypoglycemia. While there is disagreement for target glucose levels within the first 48 hours, both the AAP and the PES suggest further investigation for persistent hypoglycemia beyond 48-72 hours, which is beyond the scope of this article. However, in the immediate postnatal period, much can be gained with familiarization of the two guidelines, as well as current management techniques. This article presents current definitions and treatment modalities for management of hypoglycemia in infants considered at high risk in the immediate postnatal period.
由于早产儿出生率的增加、产妇糖尿病和产妇肥胖，新生儿期低血糖的发病率正在上升。严重低血糖被认为是神经元细胞死亡和不良神经发育结果的危险因素。美国儿科学会（AAP）建议，对于无症状的新生儿，在前 48 小时内的血糖目标值应≥45mg/dL（≥2.5mmol/L）。儿科内分泌学会（PES）建议，在前 48 小时内无法维持血糖水平＞50mg/dL（＞2.77mmol/L）或在 48 小时后＞60mg/dL（＞3.33mmol/L）的新生儿存在持续低血糖的风险。尽管在前 48 小时内的目标血糖水平存在争议，但 AAP 和 PES 都建议对 48-72 小时后持续低血糖进行进一步调查，这超出了本文的范围。然而，在新生儿期，熟悉这两个指南以及当前的管理技术可以带来很多好处。本文介绍了目前认为新生儿期存在高风险的婴儿低血糖管理的定义和治疗方法。
