PREVALENCE OF HYPOGLYCEMIA IN LOW BIRTH WEIGHT NEWBORN ADMITTED IN RAJSHAHI MEDICAL COLLEGE HOSPITAL IN 1ST 72 HOURS OF LIFE

Rahnuma Shirin*, Ahmed Masiha Jamil, Sanaul Haque Miah and Md. Jawadul Haque

ABSTRACT

Introduction: Neonatal hypoglycemia is a common metabolic problem which often goes unnoticed due to lack of specific symptoms. It is a common abnormality in low birth weight neonates. It is associated with neurological damage and death when it occurs in the first few days of life. Objective: Other objectives were to describe the presence of other clinically associated risk factors and to identify relationship between development of hypoglycemia and associated risk factors in these low birth weight newborns. Methods: This descriptive, cross sectional hospital based study was aimed to describe the prevalence of hypoglycemia in low birth weight newborn admitted in Rajshahi medical college hospital in 1st 72 hours of life. A total of 264 neonates were enrolled in the study during the period of July 2015 to June 2017. Written informed consent was obtained. Clinical assessment and 72 hours blood glucose were recorded. Serial determination of blood glucose were recorded using glucometer at 1,2,6,12, 18, 24, 36, 48, 60 and 72 hours of age. Any abnormal result was immediately confirmed by the laboratory. Results: In our study we found 9.5% (n=25) Low Birth Weight newborn had hypoglycemia. The occurrence of hypoglycemia was within 1st 0-24 hours in 60% cases (n=15), >24-48 hours in 32% cases (n=8) and >48-72 hours in 8% cases (n=2). In this study male female ratio was 1.1:1. Mean±SD birth weight was 1681.82±301.69 grams and mean gestational age was 31.70±3.60 weeks. In this study majority of mother were <20 years of age and primiparous. Mean±SD maternal age was 19.86±5.960 years and mean± SD maternal weight was 48.23±3.592 kg. There was no significant relationship between increased incidence of hypoglycemia and sex, birth weight, gestational age of the baby and maternal age, maternal weight and parity of the mother. Regarding associated risk factors we found some factors related to newborn and some factors related to the mothers. We found most important factors associated with newborn were septicaemia in 42.4% cases (p=0.022) and PNA in 33% cases (p=00.010). Septicaemia and PNA were significantly associated with hypoglycemia in low birth weight newborn. Regarding mother various risk factors were found significant. Maternal anaemia (p=0.033), PET (p=0.004), APH (p=0.011), PROM (p=0.024), prolonged labour (p=0.033) and mode of delivery (p=0.009) were found significantly associated with increased incidence of hypoglycemia in low birth weight neonate. Conclusion: So, from this study it can be inferred that hypoglycemia is more common in low birth weight newborn within 1st 24 hours of life and several associated risk factors are related to hypoglycemia. So low birth weight newborn should be kept under close observation and periodic monitoring of blood glucose should be done to avoid risk of hypoglycemia.

Keywords: Hypoglycemia, Low birth weight, Septicaemia, RDS, Apnoea, Maternal Anaemia, PET, APH, PROM.