Department of Neonatology, Women wellness and Research Centre, Hamad Medical Corporation, Doha, State of Qatar.
Department of Pediatrics, Weill Cornell Medical College, Doha, State of Qatar.
J Neonatal Perinatal Med. 2023;16(1):111-117. doi: 10.3233/NPM-221170.
Neonatal hypoglycemia is one of the most common causes of admission to neonatal intensive care unit requiring intravenous dextrose therapy. Administration of IV dextrose and transfer to the NICU may interfere with parent-infant bonding, breastfeeding, and has financial implications.
Retrospective study to evaluate the effect of dextrose gel supplementation for asymptomatic hypoglycemia in reducing NICU admissions and intravenous dextrose therapy.
A retrospective study conducted for eight months each before and after introduction of dextrose gel in the management of asymptomatic neonatal hypoglycemia. Asymptomatic hypoglycemic infants were given only feeds in pre dextrose gel period and dextrose gel along with feeds in the dextrose gel period. Rates of admission to NICU and the need of IV dextrose therapy were evaluated.
High risk characteristics (Prematurity, Large for Gestational Age, small for Gestational Age, Infants of diabetic mother etc.) were equally distributed among both the cohorts. Primary outcome results showed significant reduction in NICU admissions from 396/1801(22%) to 329/1783 (18.5%) (odds ratio, 95% CI 1.24(1.05-1.46, p 0.008). There was significant reduction in IV dextrose therapy requirement from 277/1405 (15.4%) to 182/1454 (10.2%) (odds ratio, 95% CI 1.59(1.31- 1.95, p < 0.001).Babies discharged on predominant breast feeding showed significant improvement from 237/396(59.8%) in the pre dextrose gel period to 240/329 (72.9%) (odds ratio, 95% CI 0.82(0.73-0.90, p < 0.001) in dextrose gel period.
Dextrose gel supplementation with feeds reduced NICU admissions, the need for parenteral dextrose therapy, avoided maternal separation and promoted breastfeeding.
新生儿低血糖症是导致新生儿重症监护病房（NICU）收治的最常见原因之一，需要静脉滴注葡萄糖治疗。静脉滴注葡萄糖和转入 NICU 可能会干扰母婴结合、母乳喂养，并产生经济影响。
评估葡萄糖凝胶补充治疗无症状低血糖症对减少 NICU 收治和静脉滴注葡萄糖治疗的效果。
在引入葡萄糖凝胶治疗无症状新生儿低血糖症前后，分别进行了为期八个月的回顾性研究。在葡萄糖凝胶治疗前，无症状低血糖婴儿仅给予喂养，而在葡萄糖凝胶治疗期间，给予葡萄糖凝胶和喂养。评估 NICU 收治率和静脉滴注葡萄糖治疗的需要。
高危特征（早产、巨大儿、小于胎龄儿、糖尿病母亲婴儿等）在两个队列中分布均匀。主要结局结果显示，NICU 收治率从 396/1801（22%）显著降低至 329/1783（18.5%）（比值比，95%CI 1.24（1.05-1.46，p 0.008）。静脉滴注葡萄糖治疗的需求从 277/1405（15.4%）显著降低至 182/1454（10.2%）（比值比，95%CI 1.59（1.31-1.95，p<0.001）。在主要母乳喂养的婴儿中，从葡萄糖凝胶治疗前的 396 例中的 237 例（59.8%）显著提高到 329 例中的 240 例（72.9%）（比值比，95%CI 0.82（0.73-0.90，p<0.001）。
在喂养中添加葡萄糖凝胶可减少 NICU 收治、静脉滴注葡萄糖治疗的需求、避免母婴分离和促进母乳喂养。
