Point-of-admission neonatal hypoglycaemia in a Nigerian tertiary hospital: incidence, risk factors and outcome.

Abstract

Background: Neonatal hypoglycaemia is a major metabolic problem. It may result in mortality or severe handicap among survivors. Many babies admitted for neonatal care are at high risk for hypoglycaemia. The present study set out to determine its point-of-admission prevalence, clinical presentation and outcome. Methods: Consecutive neonates who met the study criteria had plasma glucose determined at admission into the special care baby unit of Wesley Guild Hospital. Hypoglycaemia was defined as plasma glucose of ≤ 2.5mmol/L. Babies with and without hypoglycaemia were compared for risk factors, clinical features and outcome. Results: A total of 150 neonates were studied out of which 49 (32.7%) had hypoglycaemia. The mean age, 38.3 ± 71.6 in hours was significant ly lower among neonates with hypoglycaemia than those without hypoglycaemia [p = 0.006].Lowsocioeconomic class (p = 0.034), admission weight less t h a n 2500g ( p = 0.009 ) , hypothermia (p = 0.001) and preterm birth (p = 0.020) were significantly more common in babies with hypoglycaemia. Poor suck (p = 0.010), cyanosis (p = 0.020), convulsion (p = 0.040) and pallor (p = 0.048) were also more common among babies with hypoglycaemia. The mortality rate in babies with hypoglycaemia was 32.7%, higher than 18.8% in babies without hypoglycaemia but the difference was not statistically significant (p = 0.060). Conclusion: Hypoglycaemia is common among high-risk neonates and is often associated with morbidity and mortality. Routine monitoring of blood glucose is therefore recommended for this class of babies

KeyWords: Prevalence, Point-of-admission , Neonatal Hypoglycaemia, Morbidity and Mortality, Nigeria.