DISCUSSION
OF THE CAUSE OF HYPOGLYCEMIA IN NEWBORN INFANTS (DATA ANALYSIS OF 70 CASES)
Xu Mei
Department of Pediatrics, The Third Hospital of Beijing
University, Beijing, China
Objective: In order to find out the cause
of hypoglycemia in newborn infants, we monitored the blood glucose level of
344 cases that were in dangerous situations, such as low birth weight
(LBW), small gestational age (SGA), etc.
Methods: Both the glucose level of
whole blood via vein and that of peripheral blood were monitored using test
papers immediately after admission until the blood glucose level returned
to normal. Hypoglycemia was determined by the following criteria: the blood
glucose of full term infants is less than 1.7 mmol/l (30mg/dl) within 3
days after birth; the blood glucose of preterm infants or SGA infants is
less than 1.1mmol/l (20mg/dl) within 3 days after birth; the blood glucose
is less than 2.2 mmol/l (40mg/dl) after the first 3 days.
Results: 70 out of 344 (20.35%) cases
were hypoglycemic newborn infants, 58 (82.9%) of which were preterm infants
or SGA infants, and 61 (87.1%)
of which suffered intrauterine anoxia or after-birth anoxia, and 49 (70%) of which lay in both
categories above. The time points when they began to feed were as following
8 (11.4%) cases before 6th hr, 19 (27.1%) cases within 6~ 12th
hr, 43 (64.1%) cases within 12~ 24th hr. Most of the
hypoglycemic newborn infants retarded in feeding. Moreover, 30 (42.8%) of
the hypoglycemic newborn infants suffered low body temperature when the environment
were cold. After treatment, 68 cases admitted without apparent symptoms
recovered within 3 days; 1 case admitted with decreased muscular strength
recovered on the 4th day; 1SGA case admitted with convulsion,
which showed repeated occurrence of hypoglycemia and did not recover until
19 days of treatment, was diagnosed hyperinsulinemia.
Conclusion: The occurrence of hypoglycemia in newborn infants is
related to the level of maturity. Other factors such as intrauterine
anoxia, after-birth anoxia and low body temperature can also cause
hypoglycemia. Further, to those cases with persistent or repeated
hypoglycemia, Hyperinsulinemia should be considered as a possible cause.
Since hypoglycemic newborn infants are usually difficult to feed, it is
important to inject glucose via vein at different rates according to age.