Mukunya David, Odongkara Beatrice, Piloya Thereza, Nankabirwa Victoria, Achora Vincentina, Batte Charles, Ditai James, Tylleskar Thorkild, Ndeezi Grace, Kiguli Sarah, Tumwine James K
Sanyu Africa Research Institute, Mbale, Uganda.
Center for Intervention Science in Maternal and Child Health (CISMAC), Center for International Health, University of Bergen, Bergen, Norway.
Trop Med Health. 2020 Nov 4;48(1):89. doi: 10.1186/s41182-020-00275-y.
Neonatal hypoglycemia is the most common endocrine abnormality in children, which is associated with increased morbidity and mortality. The burden and risk factors of neonatal hypoglycemia in rural communities in sub-Saharan Africa are unknown.
To determine the prevalence and risk factors for neonatal hypoglycemia in Lira District, Northern Uganda.
This was a community-based cross-sectional study, nested in a cluster randomized controlled trial designed to promote health facility births and newborn care practices in Lira District, Northern Uganda. This study recruited neonates born to mothers in the parent study. Random blood glucose was measured using an On Call® Plus glucometer (ACON Laboratories, Inc., 10125 Mesa Road, San Diego, CA, USA). We defined hypoglycemia as a blood glucose of < 47 mg/dl. To determine the factors associated with neonatal hypoglycemia, a multivariable linear regression mixed-effects model was used.
We examined 1416 participants of mean age 3.1 days (standard deviation (SD) 2.1) and mean weight of 3.2 kg (SD 0.5). The mean neonatal blood glucose level was 81.6 mg/dl (SD 16.8). The prevalence of a blood glucose concentration of < 47 mg/dl was 2.2% (31/1416): 95% CI 1.2%, 3.9%. The risk factors for neonatal hypoglycemia were delayed breastfeeding initiation [adjusted mean difference, - 2.6; 95% CI, - 4.4, - 0.79] and child age of 3 days or less [adjusted mean, - 12.2; 95% CI, - 14.0, - 10.4].
The incidence of neonatal hypoglycemia was low in this community and was predicted by delay in initiating breastfeeding and a child age of 3 days or less. We therefore suggest targeted screening and management of neonatal hypoglycemia among neonates before 3 days of age and those who are delayed in the onset of breastfeeding.
新生儿低血糖是儿童中最常见的内分泌异常，与发病率和死亡率增加相关。撒哈拉以南非洲农村社区新生儿低血糖的负担和风险因素尚不清楚。
确定乌干达北部利拉区新生儿低血糖的患病率和风险因素。
这是一项基于社区的横断面研究，嵌套于一项整群随机对照试验中，该试验旨在促进乌干达北部利拉区的医疗机构分娩和新生儿护理实践。本研究招募了母研究中母亲所生的新生儿。使用On Call® Plus血糖仪（ACON Laboratories, Inc., 10125 Mesa Road, San Diego, CA, USA）测量随机血糖。我们将低血糖定义为血糖<47mg/dl。为了确定与新生儿低血糖相关的因素，使用了多变量线性回归混合效应模型。
我们检查了1416名平均年龄为3.1天（标准差（SD）2.1）、平均体重为3.2kg（SD 0.5）的参与者。新生儿平均血糖水平为81.6mg/dl（SD 16.8）。血糖浓度<47mg/dl的患病率为2.2%（31/1416）：95%置信区间为1.2%，3.9%。新生儿低血糖的风险因素是开始母乳喂养延迟[调整后平均差异，-2.6；95%置信区间，-4.4，-0.79]和儿童年龄3天及以下[调整后平均值，-12.2；95%置信区间，-14.0，-10.4]。
该社区新生儿低血糖的发生率较低，且可通过开始母乳喂养延迟和儿童年龄3天及以下来预测。因此，我们建议对3日龄前以及母乳喂养开始延迟的新生儿进行针对性的新生儿低血糖筛查和管理。
