STUDY OF MORBIDITY PATTERN OF HYPOGLYCEMIA IN NEONATES ADMITTED TO A TERTIARY CARE CENTER-AN EXPERIENCE OF TWO YEARS

Arakhita Swain*, Kedarnath Das, Suresh Kumar Tripathy, Saiprasanna Behera and Saroj Kumar Satpathy

ABSTRACT

Background: Hypoglycemia, the most common metabolic abnormality in neonates, is associated with neuronal damage and death especially when it occurs during the 1st few days of life. It is a common co-morbid condition associated with prematurity, birth asphyxia, IUGR, IDM, sepsis, various inborn errors of metabolism and endocrine disorders. The present study was conducted in SNCU of SCB Medical College and SVP PGIP, Cuttack over a period of two years with an aim to study the incidence, various clinical features, different risk factors (maternal and neonatal) as well as the morbidity and mortality pattern associated with neonatal hypoglycemia. Materials and Methods: It was a hospital based prospective observational study including 218 neonates at risk for hypoglycemia. All the babies were screened for hypoglycemia and blood samples were sent to the laboratory for confirmation of blood glucose. All the data were analysed statistically with Med Calc. Results: The incidence of hypoglycemia was 7.87% with a male preponderance i.e. 1.11:1 and more babies were delivered vaginally. The LBW (both preterm and Term SGA) babies contributed the maximum towards the incidence of hypoglycemia (55.50%) followed by Prematurity as an independent factor (48.60%), Birth asphyxia (38.07%) and SGA (14.22%) and it increased further with co-existence of two risk factors. The commonest clinical presentation was jitteriness and tremor followed by lethargy, poor feeding. Majority cases were discharged and death occurred in 7.80% while some babies were discharged with some sequelae. Conclusion: Neonatal hypoglycemia not only can cause mortality, but also may lead to serious neurological damage in newborn period. Early detection and prompt correction of hypoglycemia before occurrence of symptoms is the most important in the first step of management, but, for definite treatment the management of underlying cause is the second important and highly essential step.

Keywords: Neonatal hypoglycemia, metabolic abnormality, neurological damage.