Hypoglycemia in small for gestational age infants in a level III NICU: An observational study

To evaluate the incidence, risk factors and outcome of hypoglycemia in SGA neonates. Four hundred and eighty SGA neonates were prospectively enrolled. Antenatal, natal and postnatal risk factors were recorded. Blood sugar monitoring was routinely performed at 1, 2, 4, 6, 12, 24, 36 and 48 h of life. Severity of hypoglycemia, symptomatology, and need for intravenous fluids were also documented. Of 480 SGA neonates enrolled, 126 (26.2%) developed hypoglycemia during NICU stay. Thirteen (10%) neonates had symptomatic hypoglycemia. Ninety four percent hypoglycemic episodes occurred within 24 h of life. On univariate analysis, birth weight, gestational age, PIH and abnormal UA Doppler were significant risk factors for occurrence of hypoglycemia. On multiple logistic regression analysis, only UA Doppler abnormality remained a significant risk factor for hypoglycemia in these neonates. Severity of growth restriction was not associated with increased risk of hypoglycemia. Hypoglycemia is a common occurrence in SGA neonates. Majority of episodes of hypoglycemia occur within 24 h of age, warranting periodic blood sugar monitoring during this period and establishing early aggressive nutritional supply among these high risk neonates. Abnormal UA Doppler velocity is an independent risk factor for hypoglycemia in these neonates.