Hypoglycemia in unmonitored full-term newborns-a surveillance study
Hypoglycemia monitoring is not recommended for most full-term newborns. We wished to determine the incidence, presentation and case characteristics of hypoglycemia in low-risk newborns. With the assistance of the Canadian Paediatric Surveillance Program, we conducted a national study of severe hypog...
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| Veröffentlicht in: | Paediatrics & child health 2018-12, Vol.23 (8), p.509-514 |
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| creator | Flavin, Michael P Osiovich, Horacio Coughlin, Kevin Sgro, Michael Ray, Joel Hu, Liyuan León, Juan Andrés Gregoire, Keith Barr, Logan Gallipoli, Alessia Grewal, Karen |
| description | Hypoglycemia monitoring is not recommended for most full-term newborns. We wished to determine the incidence, presentation and case characteristics of hypoglycemia in low-risk newborns.
With the assistance of the Canadian Paediatric Surveillance Program, we conducted a national study of severe hypoglycemia in apparently low-risk full-term newborns. Paediatricians who reported a case were sent a detailed questionnaire and the data were analyzed.
All 93 confirmed cases were singletons, 56% were first-borns and 65% were male. An 8% rate of First Nations cases was twofold the population rate. Maternal hypertension rate was 23%, fourfold the general pregnancy rate. Maternal obesity was double the general pregnancy rate at 23%. Concerning signs or feeding issues were noted in 98% at the time of diagnosis. Median time to diagnosis was 4.1 hours. Mean blood glucose at intravenous (IV) start was 1.4 ± 0.5 hours (SD). Seventy-eight per cent had at least one of four potential stress indicators and were more likely to have early diagnosis (P=0.03). Major signs were present in 20%. Those cases presented later and had lower glucose levels (median=0.8 mmol/L versus 1.6 mmol/L, [P |
| doi_str_mv | 10.1093/pch/pxy025 |
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With the assistance of the Canadian Paediatric Surveillance Program, we conducted a national study of severe hypoglycemia in apparently low-risk full-term newborns. Paediatricians who reported a case were sent a detailed questionnaire and the data were analyzed.
All 93 confirmed cases were singletons, 56% were first-borns and 65% were male. An 8% rate of First Nations cases was twofold the population rate. Maternal hypertension rate was 23%, fourfold the general pregnancy rate. Maternal obesity was double the general pregnancy rate at 23%. Concerning signs or feeding issues were noted in 98% at the time of diagnosis. Median time to diagnosis was 4.1 hours. Mean blood glucose at intravenous (IV) start was 1.4 ± 0.5 hours (SD). Seventy-eight per cent had at least one of four potential stress indicators and were more likely to have early diagnosis (P=0.03). Major signs were present in 20%. Those cases presented later and had lower glucose levels (median=0.8 mmol/L versus 1.6 mmol/L, [P<0.001). Twenty-five per cent of cases had birth weight less than the 10th centile. Neurodevelopmental concern was reported in 20%. Of the 13 cases which had brain magnetic resonance imaging, 11 were abnormal.
Hypoglycemia in unmonitored newborns is uncommon but is associated with significant morbidity. We provide a range of clues to help identify these newborns soon after birth. Widespread adoption of norm-based standards to identify small-for-gestational age infants is supported.</description><identifier>ISSN: 1205-7088</identifier><identifier>EISSN: 1918-1485</identifier><identifier>DOI: 10.1093/pch/pxy025</identifier><identifier>PMID: 30842696</identifier><language>eng</language><publisher>England: Oxford University Press</publisher><subject>Blood sugar ; Canadian native peoples ; Health surveillance ; Hypertension ; Hypoglycemia ; Infants (Newborn) ; Newborn babies ; Original ; Pediatrics ; Risk factors</subject><ispartof>Paediatrics & child health, 2018-12, Vol.23 (8), p.509-514</ispartof><rights>COPYRIGHT 2018 Oxford University Press</rights><rights>The Author(s) 2018. Published by Oxford University Press on behalf of the Canadian Paediatric Society. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com</rights><rights>The Author(s) 2018. Published by Oxford University Press on behalf of the Canadian Paediatric Society. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com 2018</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c473t-811901fc0143b72d4868bc5f90f5209c0a89f33694d23dc7f69a73f7db80428e3</citedby><cites>FETCH-LOGICAL-c473t-811901fc0143b72d4868bc5f90f5209c0a89f33694d23dc7f69a73f7db80428e3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6242033/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6242033/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,315,728,781,785,886,27929,27930,53796,53798</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30842696$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Flavin, Michael P</creatorcontrib><creatorcontrib>Osiovich, Horacio</creatorcontrib><creatorcontrib>Coughlin, Kevin</creatorcontrib><creatorcontrib>Sgro, Michael</creatorcontrib><creatorcontrib>Ray, Joel</creatorcontrib><creatorcontrib>Hu, Liyuan</creatorcontrib><creatorcontrib>León, Juan Andrés</creatorcontrib><creatorcontrib>Gregoire, Keith</creatorcontrib><creatorcontrib>Barr, Logan</creatorcontrib><creatorcontrib>Gallipoli, Alessia</creatorcontrib><creatorcontrib>Grewal, Karen</creatorcontrib><title>Hypoglycemia in unmonitored full-term newborns-a surveillance study</title><title>Paediatrics & child health</title><addtitle>Paediatr Child Health</addtitle><description>Hypoglycemia monitoring is not recommended for most full-term newborns. We wished to determine the incidence, presentation and case characteristics of hypoglycemia in low-risk newborns.
With the assistance of the Canadian Paediatric Surveillance Program, we conducted a national study of severe hypoglycemia in apparently low-risk full-term newborns. Paediatricians who reported a case were sent a detailed questionnaire and the data were analyzed.
All 93 confirmed cases were singletons, 56% were first-borns and 65% were male. An 8% rate of First Nations cases was twofold the population rate. Maternal hypertension rate was 23%, fourfold the general pregnancy rate. Maternal obesity was double the general pregnancy rate at 23%. Concerning signs or feeding issues were noted in 98% at the time of diagnosis. Median time to diagnosis was 4.1 hours. Mean blood glucose at intravenous (IV) start was 1.4 ± 0.5 hours (SD). Seventy-eight per cent had at least one of four potential stress indicators and were more likely to have early diagnosis (P=0.03). Major signs were present in 20%. Those cases presented later and had lower glucose levels (median=0.8 mmol/L versus 1.6 mmol/L, [P<0.001). Twenty-five per cent of cases had birth weight less than the 10th centile. Neurodevelopmental concern was reported in 20%. Of the 13 cases which had brain magnetic resonance imaging, 11 were abnormal.
Hypoglycemia in unmonitored newborns is uncommon but is associated with significant morbidity. We provide a range of clues to help identify these newborns soon after birth. Widespread adoption of norm-based standards to identify small-for-gestational age infants is supported.</description><subject>Blood sugar</subject><subject>Canadian native peoples</subject><subject>Health surveillance</subject><subject>Hypertension</subject><subject>Hypoglycemia</subject><subject>Infants (Newborn)</subject><subject>Newborn babies</subject><subject>Original</subject><subject>Pediatrics</subject><subject>Risk factors</subject><issn>1205-7088</issn><issn>1918-1485</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><recordid>eNptkU9rFTEUxYMotj7d-AFkwI0I0978mUyyEcpDrVBwU9chk0leU2aSMZlpnW9vHq-ttpQsEpLfPTfnHoTeYzjBIOnpZK5Opz8rkOYFOsYSixoz0bwsZwJN3YIQR-hNztcADAsgr9ERBcEIl_wYbc_XKe6G1djR68qHagljDH6OyfaVW4ahnm0aq2Bvu5hCrnWVl3Rj_TDoYGyV56Vf36JXTg_ZvrvbN-jXt6-X2_P64uf3H9uzi9qwls61wFgCdgYwo11Leia46EzjJLiGgDSghXSUcsl6QnvTOi51S13bdwIYEZZu0JeD7rR0o-2NDXPSg5qSH3VaVdRePX4J_krt4o3ihBGgtAh8uhNI8fdi86xGn43de7FxyYpgIaRgonxwgz4-Qa_jkkKxpwjlRQ63Av5ROz1Y5YOLpa_Zi6ozjhsuCcG8UCfPUGX1ZegmBut8uX9U8PlQYFLMOVn34BGD2keuSuTqEHmBP_w_lQf0PmP6F_IgpvU</recordid><startdate>20181201</startdate><enddate>20181201</enddate><creator>Flavin, Michael P</creator><creator>Osiovich, Horacio</creator><creator>Coughlin, Kevin</creator><creator>Sgro, Michael</creator><creator>Ray, Joel</creator><creator>Hu, Liyuan</creator><creator>León, Juan Andrés</creator><creator>Gregoire, Keith</creator><creator>Barr, Logan</creator><creator>Gallipoli, Alessia</creator><creator>Grewal, Karen</creator><general>Oxford University Press</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8FQ</scope><scope>8FV</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ASE</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FPQ</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K6X</scope><scope>K9.</scope><scope>M0S</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20181201</creationdate><title>Hypoglycemia in unmonitored full-term newborns-a surveillance study</title><author>Flavin, Michael P ; Osiovich, Horacio ; Coughlin, Kevin ; Sgro, Michael ; Ray, Joel ; Hu, Liyuan ; León, Juan Andrés ; Gregoire, Keith ; Barr, Logan ; Gallipoli, Alessia ; Grewal, Karen</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c473t-811901fc0143b72d4868bc5f90f5209c0a89f33694d23dc7f69a73f7db80428e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Blood sugar</topic><topic>Canadian native peoples</topic><topic>Health surveillance</topic><topic>Hypertension</topic><topic>Hypoglycemia</topic><topic>Infants (Newborn)</topic><topic>Newborn babies</topic><topic>Original</topic><topic>Pediatrics</topic><topic>Risk factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Flavin, Michael P</creatorcontrib><creatorcontrib>Osiovich, Horacio</creatorcontrib><creatorcontrib>Coughlin, Kevin</creatorcontrib><creatorcontrib>Sgro, Michael</creatorcontrib><creatorcontrib>Ray, Joel</creatorcontrib><creatorcontrib>Hu, Liyuan</creatorcontrib><creatorcontrib>León, Juan Andrés</creatorcontrib><creatorcontrib>Gregoire, Keith</creatorcontrib><creatorcontrib>Barr, Logan</creatorcontrib><creatorcontrib>Gallipoli, Alessia</creatorcontrib><creatorcontrib>Grewal, Karen</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Canadian Business & Current Affairs Database</collection><collection>Canadian Business & Current Affairs Database (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>British Nursing Index</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>British Nursing Index (BNI) (1985 to Present)</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>British Nursing Index</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Paediatrics & child health</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Flavin, Michael P</au><au>Osiovich, Horacio</au><au>Coughlin, Kevin</au><au>Sgro, Michael</au><au>Ray, Joel</au><au>Hu, Liyuan</au><au>León, Juan Andrés</au><au>Gregoire, Keith</au><au>Barr, Logan</au><au>Gallipoli, Alessia</au><au>Grewal, Karen</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Hypoglycemia in unmonitored full-term newborns-a surveillance study</atitle><jtitle>Paediatrics & child health</jtitle><addtitle>Paediatr Child Health</addtitle><date>2018-12-01</date><risdate>2018</risdate><volume>23</volume><issue>8</issue><spage>509</spage><epage>514</epage><pages>509-514</pages><issn>1205-7088</issn><eissn>1918-1485</eissn><abstract>Hypoglycemia monitoring is not recommended for most full-term newborns. We wished to determine the incidence, presentation and case characteristics of hypoglycemia in low-risk newborns.
With the assistance of the Canadian Paediatric Surveillance Program, we conducted a national study of severe hypoglycemia in apparently low-risk full-term newborns. Paediatricians who reported a case were sent a detailed questionnaire and the data were analyzed.
All 93 confirmed cases were singletons, 56% were first-borns and 65% were male. An 8% rate of First Nations cases was twofold the population rate. Maternal hypertension rate was 23%, fourfold the general pregnancy rate. Maternal obesity was double the general pregnancy rate at 23%. Concerning signs or feeding issues were noted in 98% at the time of diagnosis. Median time to diagnosis was 4.1 hours. Mean blood glucose at intravenous (IV) start was 1.4 ± 0.5 hours (SD). Seventy-eight per cent had at least one of four potential stress indicators and were more likely to have early diagnosis (P=0.03). Major signs were present in 20%. Those cases presented later and had lower glucose levels (median=0.8 mmol/L versus 1.6 mmol/L, [P<0.001). Twenty-five per cent of cases had birth weight less than the 10th centile. Neurodevelopmental concern was reported in 20%. Of the 13 cases which had brain magnetic resonance imaging, 11 were abnormal.
Hypoglycemia in unmonitored newborns is uncommon but is associated with significant morbidity. We provide a range of clues to help identify these newborns soon after birth. Widespread adoption of norm-based standards to identify small-for-gestational age infants is supported.</abstract><cop>England</cop><pub>Oxford University Press</pub><pmid>30842696</pmid><doi>10.1093/pch/pxy025</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| identifier | ISSN: 1205-7088 |
| ispartof | Paediatrics & child health, 2018-12, Vol.23 (8), p.509-514 |
| issn | 1205-7088 1918-1485 |
| language | eng |
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| source | Oxford University Press Journals All Titles (1996-Current); EZB-FREE-00999 freely available EZB journals; PubMed Central |
| subjects | Blood sugar Canadian native peoples Health surveillance Hypertension Hypoglycemia Infants (Newborn) Newborn babies Original Pediatrics Risk factors |
| title | Hypoglycemia in unmonitored full-term newborns-a surveillance study |
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