Neonates at high risk of hypoglycaemia: Is admission necessary?

J Paediatr Child Health

Neonatal Unit, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.

Published: November 2022

AI Article Synopsis

  • The study assessed the routine admission of infants at high risk of hypoglycaemia, finding that 39.3% developed hypoglycaemia during the study period.
  • Initial blood glucose levels were identified as the strongest predictor for admission needs, with significantly higher odds for lower glucose levels.
  • The research suggests that monitoring these infants with their mothers could decrease unnecessary admissions and enhance breastfeeding rates.

Article Abstract

Aim: To evaluate the practice of routine admission of infants at high risk of hypoglycaemia by determining the incidence of hypoglycaemia, factors that predict necessary admission and breastfeeding outcomes.

Methods: A retrospective cohort study of neonates admitted to a tertiary neonatal unit for high risk of hypoglycaemia. Clinical data, including blood glucose concentrations, body fat percentage and time to initiation of feeding, were collected for 122 infant-maternal dyads for a 3-year period from April 2016 to May 2019. Descriptive statistical analysis and binary logistic regression analysis were undertaken.

Results: Hypoglycaemia developed in 39.3% of the neonates identified as high risk. Overall, 69 out of 122 admissions were potentially avoidable. Initial blood glucose was the most significant predictive factor for necessary admission with odds ratio of 3.26 (95% confidence interval (CI) 1.04-10.17) for an initial glucose of 1.6-2.0 and 27.05 (95% CI 5.06-144.42) for initial glucose ≤1.5. Exclusive breastfeeding rates at discharge were lower in admitted infants (59%) compared to the overall hospital rate (75.6%).

Conclusions: Neonates at high risk of hypoglycaemia should be monitored with their mothers as most infants needing admission are detected by initial blood glucose concentration. This would reduce infant-maternal separation and potentially improve breastfeeding rates.

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Source
http://dx.doi.org/10.1111/jpc.16132DOI Listing

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