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Category: Volume 05 Issue 10 October 2017
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Title: Incidence and Risk Factors of Hypoglycaemia in Large-For-Gestational Age Newborns of Non-Diabetic Mothers in a Tertiary Care Hospital

Authors: Sandeep C Prakash, Namganglung Golmei, B. Sarita, Ch. Shyamsunder, Ch. Mangi

 DOI:  https://dx.doi.org/10.18535/jmscr/v5i10.16

Abstract

Background: Large for gestational age (LGA) is defined as a weight that lies above the 90th percentile for that gestational age. Large babies are at risk of increased adverse maternal and neonatal outcomes. Neonatal complications include difficult deliveries, shoulder dystocia, plexus injuries, congenital anomalies etc. and various metabolic derangements – hypoglycemia, hyperbilirubinemia, hypocalcemia and polycythemia. The risk of hypoglycemia in LGA babies is independent of whether the mother has diabetes or not.

Aims and Objects: To determine the incidence and study the various risk factors of hypoglycaemia in LGA infants of non-diabetic mothers. Methodology: In this hospital based cross sectional descriptive study, LGA newborns delivered to non-diabetic mothers in Regional Institute of Medical Sciences (RIMS), Imphal and brought to the Department of Pediatrics, RIMS, Imphal were included in the study for blood glucose monitoring.

Results: A total of 106 LGA babies were studied during the period from 1st October 2012 to 30th September 2014. 16 (15.1%) babies were hypoglycaemic (<40mg/dl) during the first 24 hours of life. Of these, the incidence of hypoglycaemia at 2, 2-6 and 6-24 hours of life were found to be 8.5%, 3.8% and 2.8% respectively of the total hypoglycaemic cases. Hypoglycaemia was not observed in LGA babies born to mothers who were less than 20 years of age but significantly increased as mothers’ age progressed - 31.3% in 20-34 to 68.8% in more than 35 years age group (p=0.000). Babies born by LSCS operation had statistically significant hypoglycemia (p=0.041) as compared to assisted ventouse or normal deliveries. Increasing incidence of hypoglycemia occurred as the neonatal weight increased – from 8% in <4500 gm to 31% in 4500-5000 gm group (p=0.005). Babies with Apgar score <6 at 5 min was also at risk of hypoglycemia (p=0.001). No statistically significant co-relations were observed between hypoglycemia and period of gestation, parity and babies’ sex.

Keywords: LGA, newborns, LSCS, hypoglycaemia.

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Corresponding Author

Ch. Shyamsunder

Associate Professor,Department of Pediatrics,

Regional Institute of Medical Sciences, Imphal, India