The Indian Journal of Pediatrics

, Volume 67, Issue 6, pp 423–427 | Cite as

Hypoglycemia in small for gestational age babies

  • Mushtaq Ahmad Bhat
  • Praveen Kumar
  • Anil Bhansali
  • S. Majumdar
  • Anil Narang
Original Article

Abstract

The main objectives of the study were to find the incidence and risk factors associated with development of hypoglycemia in small for gestational age (SGA) babies, to compare haemoglucotest strips (Boehringer Mannheim) with the standard laboratory method (glucose-hexokinase) for estimation of blood glucose, and to measure the insulin and cortisol responses of SGA babies. This was a prospective longitudinal study. The sample included SGA babies and over a period of six months, 127 consecutively born small for gestational age babies were investigated prospectively for development of hypoglycemia in first 48 hrs of life. Plasma samples were taken during episodes of hypoglycemia for insulin and cortisol estimation and compared with non-hypoglycemic controls. The overall incidence of hypoglycemia was 25.2% in SGA babies and 98% of the episodes occurred within first 24 hrs. Compared to non-hypoglycemics, mothers of hypoglycemic babies had higher incidence of receiving i.v. fluids (5% dextrose) during labour. The hypoglycemic babies were more likely to be sick and oral feeds had been initiated by one hour of life in only 37% of them compared to 63% of non-hypoglycemic babies. Plasma insulin/glucose ratio was significantly higher in hypoglycemic than non-hypoglycemic babies, whereas the cortisol levels were similar. Small for gestational age babies are highly prone to develop hypoglycemia in first 24 hrs of life.

Key words

Haemoglucotest strip Hypoglycemia Small for gestation 

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References

  1. 1.
    Lubchencho LO, Bald H. Incidence of hypoglycemia in new born infants classified by birth weight and gestational age.Pediatrics 1971; 47: 831–838.Google Scholar
  2. 2.
    Deelu W, D Vries I. Hypoglycemia in small for date newborn infants.Pediatrics 1976; 58: 18–22.Google Scholar
  3. 3.
    Cornblath M, Gutbelat R. Neonatal hypoglycemia revisited.Pediatrics 1976; 58: 1–17.Google Scholar
  4. 4.
    Herrath A, Hsiang HU. Comparison of various methods of blood glucose screening in newborn infants.J Pediatr 1993; 102: 769–772.Google Scholar
  5. 5.
    Holtrop P, Madison K, Kiechle F. A comparison of chromogen test strips and serum glucose values in newborm.AJDC 1990; 14: 180–185.Google Scholar
  6. 6.
    Ellis M, Manandhar DS, Manandhar Net al. Comparison of two cotside methods for detection of hypoglycemia among neonates in Nepal.Arch Dis Child 1996; 75: F122-F125.Google Scholar
  7. 7.
    Pessey R, Gilium R, John Bet al. Evaluation and comparison of 10 glucose methods and reference method recommended in proposed product class standard.Clin Chem 1977; 23: 131–139.Google Scholar
  8. 8.
    Bhakoo O.N. PGI intrauterine growth chart (unpublished).Google Scholar
  9. 9.
    Welborn TA, Fraser R. Double antibody. Immunoassay of insulin.Diabetologis A 1965; 1: 211–214.CrossRefGoogle Scholar
  10. 10.
    Milner H, Hassanein K. Distribution of ponderal index by percentile group in control group of newborn infants according to fetal age.Pediatrics 1971; 48: 511–512.Google Scholar
  11. 11.
    Bland JM, Altman DG. Comparing methods of measurement: Why plotting difference against standard is misleading.Lancet 1995; 46: 1085–1087.CrossRefGoogle Scholar
  12. 12.
    Mishra PK, Sharma B. Hypoglycemia in newborn. A prospective study.Indian Pediatr 1977; 14: 129–135.Google Scholar
  13. 13.
    Ketteringham RC, Austin BR. Induced hyperglycemia at delivery.Am J Obstet Gynaecol 1939; 37: 1000–1005.Google Scholar
  14. 14.
    Singhi S, Sharma S, Gopalan Set al. Maternal glucose infusion and risk of hypoglycemia in term infants. MD thesis PGIMER, Chandigarh, 1988.Google Scholar
  15. 15.
    Griffiths A. Association of hypolycemia with symptoms in newborn.Arch Dis Child 1968; 43: 688–690.PubMedGoogle Scholar
  16. 16.
    Singhal P, Singh M, Paul V Ket al. Neonatal hypoglycemia, clinical profile and glucose requirements.Indian Pediatr 1992; 29: 167–171.PubMedGoogle Scholar
  17. 17.
    Lucas A, Morley R, Cole Tet al. Adverse neurodevelopmental outcome of moderate neonatal hypoglycemia.Br Med J 1988; 297: 1304–1308.Google Scholar
  18. 18.
    Karan S, Devi S. Hypoglycemia in newborn with special reference to starvation and feeding on blood glucose in LBW and full sized infants during first twelve hours of life.Indian Pediatr 1975; 12: 469–476.PubMedGoogle Scholar
  19. 19.
    Kirkham P, Watkins A. Comparison of two reflectance photometers in the assessment of neonatal hypoglycemia.Arch Dis Child 1995; 73: F170-F173.Google Scholar
  20. 20.
    Hawdon J, Green A, Alberi Ket al. The role of pancreatic insulin secretion in neonatal glucosulation I. Healthy term and preterm infants.Arch Dis Child 1993; 68: 274–279.PubMedCrossRefGoogle Scholar
  21. 21.
    Hawdon J. Weddell A, Aysely Get al. Hormonal and metabolic response to hypoglycemia in SGA infants.Arch Dis Child 1993; 68: 269–273.PubMedGoogle Scholar

Copyright information

© Dr. K C Chaudhuri Foundation 2000

Authors and Affiliations

  • Mushtaq Ahmad Bhat
    • 1
  • Praveen Kumar
    • 1
  • Anil Bhansali
    • 2
  • S. Majumdar
    • 3
  • Anil Narang
    • 1
  1. 1.Neonatal Unit, Department of PediatricsPostgraduate Institute of Medical Education and ResearchChandigarh
  2. 2.Department of EndocrinologyPostgraduate Institute of Medical Education and ResearchChandigarh
  3. 3.Department of Experimental MedicinePostgraduate Institute of Medical Education and ResearchChandigarh

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