Transactions of The Twenty-Second Annual Meeting of The Society for Maternal-Fetal MedicineRate and risk factors of hypoglycemia in large-for-gestational-age newborn infants of nondiabetic mothers☆
Section snippets
Study population and treatment of neonatal hypoglycemia
The study population consisted of all consecutive LGA infants who were born at the Department of Obstetrics of Vivantes Medical Center, during the 5-year period between 1994 and 1998. Current German birth weight percentiles were used to define LGA neonates (birth weight, >90th percentile).9 LGA newborns were identified in retrospect on the basis of a permanent institutional database that contains mandatory records of each delivery. Infants with major congenital anomalies were excluded.
A
Results
A total of 16,908 infants were born during the study period; 1210 infants (7.1%) were found to be LGA. Seventy-four infants were excluded because of prematurity, 180 infants were excluded because of known GDM or preexisting diabetes mellitus of the mothers, and 69 infants were excluded because of a missing measurement of neonatal glucose. Maternal and neonatal characterics of infants who were excluded because of missing glucose measurements did not differ significantly from those of the infants
Comment
To our knowledge, this is the largest published study that specifically investigated the incidence and risk factors of hypoglycemia in LGA newborn infants from nondiabetic mothers. Our study has three major findings. First, hypoglycemia occurred in 16% of these infants. Second, most infants were diagnosed within the first 5 hours of life. Third, the 1-hour postchallenge glucose value of the maternal oGTT was found to be the only useful predictor for neonatal hypoglycemia. A single abnormal oGTT
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Cited by (52)
Strategies to improve neurodevelopmental outcomes in babies at risk of neonatal hypoglycaemia
2021, The Lancet Child and Adolescent HealthCitation Excerpt :Other risk factors include neonatal illness (such as birth asphyxia or sepsis) and poor feeding. Babies who are born large for gestational age after a non-diabetic pregnancy are also at risk of neonatal hypoglycaemia.28 It is unknown if hypoglycaemia in these babies is pathological, since there is little evidence that they are at increased risk of long-term neurodevelopmental impairment.29
Short- and Long-Term Outcomes Associated with Large for Gestational Age Birth Weight
2021, Obstetrics and Gynecology Clinics of North AmericaCitation Excerpt :Among LGA infants of women without diabetes, hypoglycemia occurred in 10.5% and seizures possibly related to hypoglycemia occurred in 0.2% of these infants.29 In another large case series of 887 LGA infants (birth weight of >90th percentile) born to women without diabetes, 16% had hypoglycemia (blood glucose level of <40 mg/dL) during the first 24 hours of life.30 These data highlight the importance of routine postdelivery glucose monitoring in infants with LGA birth weight.
Pathophysiology and Management of Disorders of Carbohydrate Metabolism and Neonatal Diabetes
2020, Maternal-Fetal and Neonatal Endocrinology: Physiology, Pathophysiology, and Clinical ManagementPathophysiology and Management of Disorders of Carbohydrate Metabolism and Neonatal Diabetes
2019, Maternal-Fetal and Neonatal Endocrinology: Physiology, Pathophysiology, and Clinical ManagementIncidence of hypoglycemia in newborns at risk and an audit of the 2011 American academy of pediatrics guideline for hypoglycemia
2018, Pediatrics and NeonatologyCitation Excerpt :Although several studies support this hypothesis, other studies showed no difference in hypoglycemia incidence to that of healthy term AGA infants.7,8 In a large-scale study supporting routine glucose monitoring, Schaefer et al.12 found that 16% of LGA infants had blood glucose level of ≤30 mg/dL in the first 24 h, and this rate dropped rapidly in the first few hours. In their study hypoglycemia incidence was 9.2% in the first hour, 3.5% in 2–5 h and 2.4% later.
Glucose
2018, Volpe's Neurology of the Newborn
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