Prolonged transitional neonatal hypoglycaemia: characterisation of a clinical syndrome

Background: We performed a case-control study to characterise infants with “prolonged transitional hypoglycaemia”. Methods: Cases were born ≥36 weeks’ gestation; had ≥1 hypoglycaemic episode <72h and ≥72h; received ongoing treatment for hypoglycaemia ≥72h; and were without congenital disorders or acute illness. Cases were compared to controls born ≥36 weeks’ with brief transitional hypoglycaemia, resolving <72h. Results: 39/471 infants screened met case definition: 71.8% were male, 61.5% were small-for-gestational-age (SGA), and most were admitted <6h. Compared to controls (N=75), key risk factors for prolonged transitional hypoglycaemia were SGA (OR=6.4, 95%CI 2.7–15.1), severe/recurrent hypoglycaemia <24h (OR=16.7, 95%CI 4.5–16.1), intravenous glucose bolus <24h (OR=26.6, 95%CI 9.4–75.1) and maximum glucose delivery rate <48h of ≥8mg/kg/min (OR=25.5, 95%CI 7.7–84.1). Conclusions: Infants with prolonged transitional hypoglycaemia are predominantly male, SGA and have early severe/ recurrent hypoglycaemia requiring glucose boluses and high glucose delivery rates in the first 24–48h.

Published in Journal of Perinatology 2020 https://doi.org/10.1038/s41372-020-00891-w

Published data are available to approved researchers under the data sharing arrangements provided by the Clinical Data Research Hub (CCRH), based at the Liggins Institute, University of Auckland. Contact researchhub@auckland.ac.nz

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