Pediatrics & Therapeutics
Open Access

Abstract

Risk factors for Hypoglycaemia with Hypothermia in Neonates: An audit in a level II Special Care Nursery

Chia Saw*, Jason Tan, Ravisha Srinivasjois

Background and Objective: Hypoglycaemia is a common metabolic disorder in newborns. The aims of this retrospective study were to identify modifiable risk factors for hypoglycaemia and review the evidence to introduce common neonatal hypoglycaemia and hypothermia care bundle.
Method: This study is conducted and reported using the STROBE Statement Guideline. A retrospective audit was done on all neonatal admission to this level 2 Special Care Nursery (SCN) from 1st January 2018 to 31st December 2018. Neonates were included if they had a primary diagnosis of ‘hypoglycaemia’. Neonates with other chief diagnosis were excluded (including prematurity and sepsis). Hypoglycaemia was defined as a blood glucose level (BGL) less than 2.6mmol/L. Demographic data and risk factors were extracted from the medical records.
Main Results: The total number of SCN admissions during that period was 1020. A total of 105 infants met the inclusion criteria (n=105). The mean BGL was 1.9mmol/L. Risk factors of hypoglycaemia in the included sample identified were: maternal gestational diabetes mellitus (GDM) on diet control (13%) or insulin (29%), insulin-dependent diabetes mellitus (IDDM) (2%), beta-blockers (2%), macrosomia (4%), and Small for gestational age (7%).
Temperature analysis revealed that almost half of all hypoglycemic neonates (49.5%) were hypothermic with a temperature of below 36.5°C. 22.8% of the sample group had a temperature of below 36°C. Majority of these hypoglycemic hypothermic newborns (63%) were born via caesarean section.
Conclusion: Hypothermia is common in the newborns with hypoglycaemia. However, it is difficult to ascertain which is the primary condition. As a result of this audit, a ‘hypothermia hypoglycaemia care bundle’ has been developed to reduce overall neonatal admissions to the nursery from hypoglycaemia and/or hypothermia

Published Date: 2021-01-03; Received Date: 2020-12-03