Regev Assaf, Srour Rasha, Mangel Laurence, Mandel Dror, Herzlich Jacky, Lavie Anat, Marom Ronella
Pediatric Infectious Diseases Unit, Dana Dwek Children's Hospital, Tel Aviv Medical Center, Tel Aviv 6423906, Israel.
Faculty of Medical & Health Sciences, Tel Aviv University, Tel Aviv 6997801, Israel.
Children (Basel). 2025 Apr 16;12(4):510. doi: 10.3390/children12040510.
This study assessed the utility of capillary blood cartridge-based analysis in evaluating neonatal jitteriness (NJ).
In this retrospective study, we compared outcomes between neonates (37-41 weeks of gestation) diagnosed with neonatal jitteriness (NJ) within the first 72 h of life and a control group of healthy neonates (GA 37-41 weeks) with an uneventful perinatal course and no signs of jitteriness.
Each group included 101 neonates. Jittery neonates had a higher proportion of males (70.3% vs. 50.5%, = 0.004), a lower mean gestational age (38.8 vs. 39.2 weeks, = 0.002), and a higher rate of emergency cesarean deliveries (14.9% vs. 3.0%, = 0.003). The logistic regression identified male sex (OR = 2.5, = 0.007) and in utero selective serotonin reuptake inhibitor (SSRI) exposure (OR = 9.0, = 0.005) as significant risk factors for NJ. The capillary blood parameters, except glucose levels, did not differ significantly between the neonates admitted to the NICU and those discharged. Hypoglycemic jittery neonates were 10 times more likely to require NICU admission compared to their non-hypoglycemic counterparts (OR = 10.9, 95% CI: 2-59.5, = 0.006).
Point-of-care glucose testing using a bedside glucometer may be sufficient for the evaluation of neonatal jitteriness, as capillary blood cartridge-based testing did not offer an additional diagnostic value.
NJ is often viewed as a self-resolving benign phenomenon; however, in certain cases, it can be an indicator of an underlying pathology. There is substantial evidence linking the maternal use of SSRIs or SNRIs during pregnancy with the occurrence of NJ in newborns as well as an association between hypoglycemia and NJ.
This study is the first to evaluate the clinical utility of systematic capillary blood cartridge-based testing in jittery neonates using a relatively large cohort. Male neonates were disproportionately represented among cases of NJ. Healthy neonates with jitteriness had normal electrolytes, with hypoglycemia as the only concern. A glucometer test may suffice for evaluation, but those who are small for their gestational age or have initial hypoglycemia require a routine follow-up due to a higher risk of NICU admission.
本研究评估了基于毛细血管血样盒分析在评估新生儿颤抖（NJ）方面的效用。
在这项回顾性研究中，我们比较了出生后72小时内被诊断为新生儿颤抖（NJ）的新生儿（孕周37 - 41周）与围产期过程平稳且无颤抖迹象的健康新生儿对照组（孕周37 - 41周）的情况。
每组包括101名新生儿。颤抖的新生儿中男性比例更高（70.3%对50.5%，P = 0.004），平均孕周更低（38.8周对39.2周，P = 0.002），急诊剖宫产率更高（14.9%对3.0%，P = 0.003）。逻辑回归确定男性性别（比值比[OR]=2.5，P = 0.007）和宫内选择性5-羟色胺再摄取抑制剂（SSRI）暴露（OR = 9.0，P = 0.005）是新生儿颤抖的重要危险因素。入住新生儿重症监护病房（NICU）的新生儿和出院新生儿之间，除血糖水平外，毛细血管血参数无显著差异。与非低血糖的颤抖新生儿相比，低血糖的颤抖新生儿入住NICU的可能性高10倍（OR = 10.9，95%可信区间：2 - 59.5，P = 0.006）。
使用床边血糖仪进行即时血糖检测可能足以评估新生儿颤抖，因为基于毛细血管血样盒的检测未提供额外的诊断价值。
新生儿颤抖通常被视为一种会自行缓解的良性现象；然而，在某些情况下，它可能是潜在病理状况的一个指标。有大量证据表明母亲在孕期使用SSRI或SNRI与新生儿发生新生儿颤抖有关，以及低血糖与新生儿颤抖之间存在关联。
本研究首次使用相对较大的队列评估了基于系统毛细血管血样盒检测在颤抖新生儿中的临床效用。男性新生儿在新生儿颤抖病例中占比过高。有颤抖症状的健康新生儿电解质正常，唯一需要关注的是低血糖。血糖仪检测可能足以进行评估，但那些小于孕周或初始有低血糖的新生儿因入住NICU的风险较高，需要进行常规随访。
