Pediatrics. 2022 Jun 1;149(6). doi: 10.1542/peds.2021-050733.
Hypoglycemia occurs in 5% to 15% of neonates in the first few days. A significant proportion requires admission for intravenous fluids. Dextrose gel may reduce admissions and mother-infant separation. We aimed to study the utility of dextrose gel in reducing the need for intravenous fluids.
This stratified randomized control trial included at-risk infants with asymptomatic hypoglycemia. Study populations were stratified into 3 categories: small for gestational age (SGA) and intrauterine growth-restriction (IUGR), infants of diabetic mothers (IDM) and large for gestational age (LGA), and late preterm (LPT) neonates. Intervention group received dextrose gel followed by breastfeeding, and the control group (CG) received only breastfeeding.
Among 629 at-risk infants, 291 (46%) developed asymptomatic hypoglycemia; 147 (50.4%) in the dextrose gel group (DGG) and 144 (49.6%) in CG. There were 97, 98, and 96 infants in SGA/IUGR, IDM/LGA, and LPT categories, respectively. Treatment failure in the DGG was 17 (11.5%) compared to 58 (40.2%) in CG, with a risk ratio of 0.28 (95% confidence interval [CI]: 0.17-0.46; P < .001). Treatment failure was significantly less in DGG in all 3 categories: SGA/IUGR, IDM/LGA, and LPT with a risk ratio of 0.29 (95% CI:0.13-0.67), 0.31 (95% CI:0.14-0.66) and 0.24 (95% CI:0.09-0.66), respectively.
Dextrose gel reduces the need for intravenous fluids in at-risk neonates with asymptomatic hypoglycemia in the first 48 hours of life.
在最初几天，5%至 15%的新生儿会出现低血糖。很大一部分需要静脉补液治疗。葡萄糖凝胶可能会减少住院治疗和母婴分离。我们旨在研究葡萄糖凝胶在减少静脉补液需求方面的作用。
本分层随机对照试验纳入无症状低血糖的高危婴儿。研究人群分为 3 类：小于胎龄儿（SGA）和宫内生长受限（IUGR）、糖尿病母亲婴儿（IDM）和大于胎龄儿（LGA）、晚期早产儿（LPT）。干预组接受葡萄糖凝胶治疗，然后进行母乳喂养，对照组（CG）仅接受母乳喂养。
在 629 名高危婴儿中，291 名（46%）发生无症状低血糖；葡萄糖凝胶组（DGG）147 例（50.4%），CG 组 144 例（49.6%）。SGA/IUGR、IDM/LGA 和 LPT 类别中分别有 97、98 和 96 名婴儿。DGG 组治疗失败 17 例（11.5%），CG 组 58 例（40.2%），风险比为 0.28（95%置信区间[CI]：0.17-0.46；P<0.001）。在所有 3 个类别中，DGG 的治疗失败率均显著降低：SGA/IUGR、IDM/LGA 和 LPT 的风险比分别为 0.29（95%CI：0.13-0.67）、0.31（95%CI：0.14-0.66）和 0.24（95%CI：0.09-0.66）。
葡萄糖凝胶可减少生命最初 48 小时内无症状低血糖高危新生儿对静脉补液的需求。
