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Prolonged transitional neonatal hypoglycaemia: characterisation of a clinical syndrome

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Abstract

Background

We performed a case-control study to characterise infants with “prolonged transitional hypoglycaemia”.

Methods

Cases were born ≥36 weeks’ gestation; had ≥1 hypoglycaemic episode <72 h and ≥72 h; received ongoing treatment for hypoglycaemia ≥72 h; and were without congenital disorders or acute illness. Cases were compared to controls born ≥36 weeks’ with brief transitional hypoglycaemia, resolving <72 h.

Results

39/471 infants screened met case definition: 71.8% were male, 61.5% were small-for-gestational-age (SGA), and most were admitted <6 h. Compared to controls (N = 75), key risk factors for prolonged transitional hypoglycaemia were SGA (OR = 6.4, 95%CI 2.7–15.1), severe/recurrent hypoglycaemia <24 h (OR = 16.7, 95%CI 4.5–16.1), intravenous glucose bolus <24 h (OR = 26.6, 95%CI 9.4–75.1) and maximum glucose delivery rate <48 h of ≥8 mg/kg/min (OR = 25.5, 95%CI 7.7–84.1).

Conclusions

Infants with prolonged transitional hypoglycaemia are predominantly male, SGA and have early severe/recurrent hypoglycaemia requiring glucose boluses and high glucose delivery rates in the first 24–48 h.

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Data availability

Published data are available to approved researchers under the data sharing arrangements provided by the Clinical Data Research Hub (CCRH), based at the Liggins Institute, University of Auckland (https://wiki.auckland.ac.nz/researchhub). Metadata, along with instructions for data access, are available at the University of Auckland’s research data repository, Figshare (https://auckland.figshare.com). Data access requests are to be submitted to Data Access Committee via researchhub@auckland.ac.nz. De-identified published data will be shared with researchers who provide a methodologically sound proposal and have appropriate ethical and institutional approval. Researchers must sign and adhere to the Data Access Agreement that includes a commitment to using the data only for the specified proposal, to refrain from any attempt to identify individual participants, to store data securely and to destroy or return the data after completion of the project. The CDRH reserves the right to charge a fee to cover the costs of making data available, if required.

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Acknowledgements

Lisa Mravicich is a non-author contributor; she assisted with chart review and data entry (Liggins Institute, University of Auckland and Kidz First, Counties Manukau Health, Auckland, New Zealand). We thank the pre-hPOD Trial Steering Group for providing control data (Jane M Alsweiler, Caroline A Crowther, Richard Edlin, Greg D Gamble, Jane E Harding).

Funding:

This study was unfunded.

Author information

Authors and Affiliations

  1. Starship Children’s Health, Auckland District Health Board, Auckland, New Zealand

    Miranda J. Bailey, Jane M. Alsweiler & Wayne S. Cutfield

  2. Kidz First, Counties Manukau Health, Auckland, New Zealand

    Miranda J. Bailey, Allie Rout & Christopher J. D. McKinlay

  3. Liggins Institute, University of Auckland, Auckland, New Zealand

    Jane E. Harding, Wayne S. Cutfield & Christopher J. D. McKinlay

  4. Department of Paediatrics: Child and Youth Health, University of Auckland, Auckland, New Zealand

    Jane M. Alsweiler

  5. A Better Start Science Challenge, Auckland, New Zealand

    Wayne S. Cutfield

Authors
  1. Miranda J. Bailey
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  2. Allie Rout
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  3. Jane E. Harding
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  4. Jane M. Alsweiler
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  6. Christopher J. D. McKinlay
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Correspondence to Christopher J. D. McKinlay.

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Bailey, M.J., Rout, A., Harding, J.E. et al. Prolonged transitional neonatal hypoglycaemia: characterisation of a clinical syndrome. J Perinatol 41, 1149–1157 (2021). https://doi.org/10.1038/s41372-020-00891-w

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