Study of Blood Glucose Levels in Exclusively Breastfed Neonates Who Are at Risk of Developing Hypoglycemia

Umesh Kumar Gurjar, Prajjwal Jain, Manohar Lal Gupta

Abstract

Background: High-risk neonates, those who are at risk of developing hypoglycemia due to maternal or neonatal factors, fail to adapt due to immaturity, illnesses, or inadequate substrate. Hence, hypoglycemia can cause permanent brain damage and neurological sequelae or death in such neonates.

Aim: The aims of our study were to assess blood glucose levels in exclusively breastfed high-risk neonates during the first 24 hours of life, and to determine the risk factors associated with the development of hypoglycemia.

Materials and Methods: In our study, 250 high-risk neonates (who were at risk of developing hypoglycemia, kept in the postnatal ward with their mothers, and on exclusive breastfeeding up to 24 hours of life) were enrolled. This hospital-based observational prospective study was conducted in Sir Padampat Mother and Child Health Institute and Attached Group of Hospitals (Jaipur, Rajasthan, India), between September 2018 and August 2019. The neonates were monitored for blood glucose levels at 2, 12, and 24 hours of life. Glucose levels in these neonates were evaluated using the strip method, which were further confirmed using glucose oxidase method.

Results: The study results showed that hypoglycemia was observed in almost all neonates with maternal risk factors (of the 250 neonates, 45 were hypoglycemic). Significant hypoglycemia was found in preterm (26.67%) and term (23.19%) neonates compared with late preterm neonates (12.50%). The maximum number of neonates are hypoglycemic at 2 hours (16.4%), followed by at 12 hours (5.2%) and at 24 hours of postnatal life (0.8%). This observation was found to be statistically significant in comparison to normoglycemic group.

Conclusion: Hypoglycemia is frequently observed in the first 2 hours of life (16.4%), and many neonates remain asymptomatic. Hence, early and frequent blood glucose level monitoring should be done in high-risk neonates to diagnose hypoglycemia so that timely intervention can be planned.