Diagnosis of Persistent Hypoglycemia in a Newborn Unit: Characteristics for a Five-Year Analysis
Published
Aug 28, 2023
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María Carolina Serrano Sepúlveda
https://orcid.org/0000-0002-3981-2650
Cindy Margarita Atencia
https://orcid.org/0000-0001-6840-6021
Adriana del Pilar Montealegre
https://orcid.org/0000-0001-5464-2701
María Juliana Silva Valencia
https://orcid.org/0000-0001-8344-0340
Ángela Camila Gómez G.
https://orcid.org/0000-0002-8890-7189
Verónica Herrera
https://orcid.org/0000-0002-3981-2650
Cindy Margarita Atencia
https://orcid.org/0000-0001-6840-6021
Adriana del Pilar Montealegre
https://orcid.org/0000-0001-5464-2701
María Juliana Silva Valencia
https://orcid.org/0000-0001-8344-0340
Ángela Camila Gómez G.
https://orcid.org/0000-0002-8890-7189
Verónica Herrera
##plugins.themes.bootstrap3.article.details##
Abstract
Objective: To characterise patients with persistent hypoglycaemia seen from 1 January 2016 to 31 December 2021 in the neonatal unit of the Hospital Universitario San Ignacio (Colombia). Methodology: Descriptive study of historical cohort. Results: Of 6452 newborns hospitalised in the neonatal unit of the Hospital San Ignacio, 390 (6%) had a diagnosis of hypoglycaemia. Of these latter patients, 17 (4.3% of the total) had persistent hypoglycaemia. The cumulative incidence per year was between 2% and 11%. In the same period, for every 1000 hospital admissions to the neonatal unit, between 1 and 7 patients had a diagnosis of persistent hypoglycaemia. Conclusions: Persistent hypoglycaemia is a rare entity; however, it should always be taken into account when diagnosing neonatal hypoglycaemia; additionally, critical sampling should be performed in the period of hypoglycaemia to establish the aetiology and provide appropriate treatment.
Keywords
unidad de recién nacidos, hipoglucemia, neonatos, glucosapersistent neonatal hypoglycemia, newborns, neonates, newborn unit
References
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23. Sumikura H. Neonatal hypoglycemia after cesarean section. J Anesth 2013;27(2):167-8. htts://doi.org/10.1007/s00540-013-1574-z
24. Cornblath M, Hawdon JM, Williams AF, Aynsley-Green A, Ward-Platt MP, Schwartz R, et al. Controversies regarding definition of neonatal hypoglycemia: suggested operational thresholds. Pediatrics. 2000;105(5):1141-5. htts://doi.org/10.1542/peds.105.5.1141
25. Pedraza-Flechas PV, Pereira-Ospina RP, Molinares-Mejía JS, Suescún-Vargas JM, Pinzón-Salamanca JY. Hiperinsulinismo congénito: caracterización de pacientes atendidos en un hospital universitario pediátrico en Colombia. Bol Med Hosp Infant Mex. 2020;77(2). https://doi.org/10.24875/bmhim.19000133
26. Sweet CB, Grayson S, Polak M. Management strategies for neonatal hypoglycemia. J Pediatr Pharmacol Ther. 2013 Jul;18(3):199-208. htts://doi.org/10.5863/1551-6776-18.3.199
27. Hussein SM, Salih Y, Rayis DA, Bilal JA, Adam I. Low neonatal blood glucose levels in cesarean-delivered term newborns at Khartoum Hospital, Sudan. Diagn Pathol. 2014;9(1). htts://doi.org/10.1186/1746-1596-9-112
28. Meissner T, Mayatepek E. Clinical and genetic heterogeneity in congenital hyperinsulinism. Eur J Pediatr. 2002;161(1):6-20. htts://doi.org/10.1007/s004310100850
29. Leiva Gea I, Ramos JM, Borrás Pérez V, López Siguero JP. Hipoglucemia. Protoc Diagn Ter Pediatr. 2019;(1):171-82.
30. Sharma D, Shastri S, Sharma P. Intrauterine growth restriction: antenatal and postnatal aspects. Clin Med Insights Pediatr. 2016;10:67-83. htts://doi.org/10.4137/CMPed.S40070
2. Wackernagel D, Gustafsson A, Edstedt Bonamy A-K, Reims A, Ahlsson F, Elfving M, et al. Swedish national guideline for prevention and treatment of neonatal hypoglycaemia in newborn infants with gestational age ≥35 weeks. Acta Paediatr. 2020;109(1):31-44. https://doi.org/10.1111/apa.14955
3. Committee on Fetus and Newborn, Adamkin DH. Postnatal glucose homeostasis in late-preterm and term infants. Pediatrics. 2011;127(3):575-9. https://doi.org/10.1542/peds.2010-3851
4. Adamkin DH. Neonatal hypoglycemia. Semin Fetal Neonatal Med. 2017;22(1):36-41. https://doi.org/10.1016/j.siny.2016.08.007
5. Edwards T, Harding JE. Clinical aspects of neonatal hypoglycemia: a mini review. Front Pediatr. 2020;8:562251. https://doi.org/10.3389/fped.2020.562251
6. Thornton PS, Stanley CA, De Leon DD, Harris D, Haymond MW, Hussain K, et al. Recommendations from the pediatric endocrine society for evaluation and management of persistent hypoglycemia in neonates, infants, and children. J Pediatr. 2015;167(2):238-45. https://doi.org/10.1016/j.jpeds.2015.03.057
7. Marles SL, Casiro OG. Persistent neonatal hypoglycemia: diagnosis and management. Paediatr Child Health. 1998;3(1):16-9. htts://doi.org/10.1093/pch/3.1.16
8. British Association of Perinatal Medicine. Identification and management of neonatal hypoglycaemia in the full term infant: framework to practice [internet]. 2017 [citado 2023 jun 22]. Disponible en: https://hubble-live-assets.s3.amazonaws.com/bapm/attachment/file/53/Identification_and_Management_of_Neonatal_Hypoglycaemia_in_the__full_term_infant_-_A_Framework_for_Practice_revised_Oct_2017.pdf
9. Cowett RM, Loughead JL. Neonatal glucose metabolism: differential diagnoses, evaluation, and treatment of hypoglycemia. Neonatal Netw. 2002;21(4):9-19. htts://doi.org/10.1891/0730-0832.21.4.9.
10. Riliang LIN. Investigation on the occurrence of neonatal hypoglycemia in Meizhou People’s Hospital in 2017-2018. J Public Health Prev Med. 2021;(6):151-4.
11. Skovrlj R, Marks SD, Rodd C. Frequency and etiology of persistent neonatal hypoglycemia using the more stringent 2015 Pediatric Endocrine Society hypoglycemia guidelines. Paediatr Child Health. 2019 Jun 21;24(4):263-9. htts://doi.org/10.1093/pch/pxy166
12. Banerjee I, Salomon-Estebanez M, Shah P, Nicholson J, Cosgrove KE, Dunne MJ. Therapies and outcomes of congenital hyperinsulinism-induced hypoglycaemia. Diabet Med. 2019;36(1):9-21. htts://doi.org/10.1111/dme.13823
13. Pertierra Cortada Á, Iglesias Platas I. Hipoglucemia neonatal. An Pediatr Contin. 2013;11(3):142-51. htts://doi.org/10.1016/S1696-2818(13)70130-6
14. Narvey MR, Marks SD. The screening and management of newborns at risk for low blood glucose. Paediatr Child Health. 2019;24(8):536-54. htts://doi.org/10.1093/pch/pxz134
15. Alsaleem M, Saadeh L, Kamat D. Neonatal hypoglycemia: a review. Clin Pediatr (Phila). 2019;58(13):1381-6. htts://doi.org/10.1177/0009922819875540
16. Wight NE, Academy of Breastfeeding Medicine. ABM clinical protocol #1: guidelines for glucose monitoring and treatment of hypoglycemia in term and late preterm neonates, revised 2021. Breastfeed Med. 2021;16(5):353-65. htts://doi.org/10.1089/bfm.2021.29178.new
17. Glaser B, Thornton P, Otonkoski T, Junien C. Genetics of neonatal hyperinsulinism. Arch Dis Child Fetal Neonatal Ed. 2000;82(2):F79-86. htts://doi.org/10.1136/fn.82.2.f79
18. Kumar U, Bihari Singh B. Determine the clinical profile of hypoglycemia in newborn and to determine the prevalence of hypoglycemia among neonates admitted in NICU. Eur J Mol Clin Med. 2020;7(10):3738-43.
19. McInern TK, Adam HM, Campbell DE, DeWitt TG, Meschan Foy J, Kamat DM, editores. Textbook of pediatric care. 2.ª ed. Elk Grove Village, Il: American Academy of Pediatrics; 2017.
20. Newman-Lindsay S, Lakshminrusimha S, Sankaran D. Diazoxide for neonatal hyperinsulinemic hypoglycemia and pulmonary hypertension. Children (Basel). 2022;10(1):5. htts://doi.org/10.3390/children10010005
21. McKinlay CJD, Alsweiler JM, Anstice NS, Burakevych N, Chakraborty A, Chase JG, et al. Association of neonatal glycemia with neurodevelopmental outcomes at 4.5 years. JAMA Pediatr. 2017;171(10):972-83. htts://doi.org/10.1001/jamapediatrics.2017.1579
22. Puchalski ML, Russell TL, Karlsen KA. Neonatal hypoglycemia: is there a sweet spot? Crit Care Nurs Clin North Am. 2018;30(4):467-80. htts://doi.org/10.1016/j.cnc.2018.07.004
23. Sumikura H. Neonatal hypoglycemia after cesarean section. J Anesth 2013;27(2):167-8. htts://doi.org/10.1007/s00540-013-1574-z
24. Cornblath M, Hawdon JM, Williams AF, Aynsley-Green A, Ward-Platt MP, Schwartz R, et al. Controversies regarding definition of neonatal hypoglycemia: suggested operational thresholds. Pediatrics. 2000;105(5):1141-5. htts://doi.org/10.1542/peds.105.5.1141
25. Pedraza-Flechas PV, Pereira-Ospina RP, Molinares-Mejía JS, Suescún-Vargas JM, Pinzón-Salamanca JY. Hiperinsulinismo congénito: caracterización de pacientes atendidos en un hospital universitario pediátrico en Colombia. Bol Med Hosp Infant Mex. 2020;77(2). https://doi.org/10.24875/bmhim.19000133
26. Sweet CB, Grayson S, Polak M. Management strategies for neonatal hypoglycemia. J Pediatr Pharmacol Ther. 2013 Jul;18(3):199-208. htts://doi.org/10.5863/1551-6776-18.3.199
27. Hussein SM, Salih Y, Rayis DA, Bilal JA, Adam I. Low neonatal blood glucose levels in cesarean-delivered term newborns at Khartoum Hospital, Sudan. Diagn Pathol. 2014;9(1). htts://doi.org/10.1186/1746-1596-9-112
28. Meissner T, Mayatepek E. Clinical and genetic heterogeneity in congenital hyperinsulinism. Eur J Pediatr. 2002;161(1):6-20. htts://doi.org/10.1007/s004310100850
29. Leiva Gea I, Ramos JM, Borrás Pérez V, López Siguero JP. Hipoglucemia. Protoc Diagn Ter Pediatr. 2019;(1):171-82.
30. Sharma D, Shastri S, Sharma P. Intrauterine growth restriction: antenatal and postnatal aspects. Clin Med Insights Pediatr. 2016;10:67-83. htts://doi.org/10.4137/CMPed.S40070
How to Cite
Serrano Sepúlveda, M. C., Atencia, C. M., Montealegre, A. del P., Silva Valencia, M. J., Gómez G., Ángela C., & Herrera, V. (2023). Diagnosis of Persistent Hypoglycemia in a Newborn Unit: Characteristics for a Five-Year Analysis. Universitas Medica, 64(3). https://doi.org/10.11144/Javeriana.umed64-3.cpdh
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Suplemento Especial de Pedriatría
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