Miranda J Bailey1,2, Allie Rout2, Jane E Harding3, Jane M Alsweiler1,4, Wayne S Cutfield1,3,5, Christopher J D McKinlay6,7. 1. Starship Children's Health, Auckland District Health Board, Auckland, New Zealand. 2. Kidz First, Counties Manukau Health, Auckland, New Zealand. 3. Liggins Institute, University of Auckland, Auckland, New Zealand. 4. Department of Paediatrics: Child and Youth Health, University of Auckland, Auckland, New Zealand. 5. A Better Start Science Challenge, Auckland, New Zealand. 6. Kidz First, Counties Manukau Health, Auckland, New Zealand. c.mckinlay@auckland.ac.nz. 7. Liggins Institute, University of Auckland, Auckland, New Zealand. c.mckinlay@auckland.ac.nz.
Abstract
BACKGROUND: We performed a case-control study to characterise infants with "prolonged transitional hypoglycaemia". METHODS: Cases were born ≥36 weeks' gestation; had ≥1 hypoglycaemic episode <72 h and ≥72 h; received ongoing treatment for hypoglycaemia ≥72 h; and were without congenital disorders or acute illness. Cases were compared to controls born ≥36 weeks' with brief transitional hypoglycaemia, resolving <72 h. RESULTS: 39/471 infants screened met case definition: 71.8% were male, 61.5% were small-for-gestational-age (SGA), and most were admitted <6 h. Compared to controls (N = 75), key risk factors for prolonged transitional hypoglycaemia were SGA (OR = 6.4, 95%CI 2.7-15.1), severe/recurrent hypoglycaemia <24 h (OR = 16.7, 95%CI 4.5-16.1), intravenous glucose bolus <24 h (OR = 26.6, 95%CI 9.4-75.1) and maximum glucose delivery rate <48 h of ≥8 mg/kg/min (OR = 25.5, 95%CI 7.7-84.1). CONCLUSIONS: Infants with prolonged transitional hypoglycaemia are predominantly male, SGA and have early severe/recurrent hypoglycaemia requiring glucose boluses and high glucose delivery rates in the first 24-48 h.
BACKGROUND: We performed a case-control study to characterise infants with "prolonged transitional hypoglycaemia". METHODS: Cases were born ≥36 weeks' gestation; had ≥1 hypoglycaemic episode <72 h and ≥72 h; received ongoing treatment for hypoglycaemia ≥72 h; and were without congenital disorders or acute illness. Cases were compared to controls born ≥36 weeks' with brief transitional hypoglycaemia, resolving <72 h. RESULTS: 39/471 infants screened met case definition: 71.8% were male, 61.5% were small-for-gestational-age (SGA), and most were admitted <6 h. Compared to controls (N = 75), key risk factors for prolonged transitional hypoglycaemia were SGA (OR = 6.4, 95%CI 2.7-15.1), severe/recurrent hypoglycaemia <24 h (OR = 16.7, 95%CI 4.5-16.1), intravenous glucose bolus <24 h (OR = 26.6, 95%CI 9.4-75.1) and maximum glucose delivery rate <48 h of ≥8 mg/kg/min (OR = 25.5, 95%CI 7.7-84.1). CONCLUSIONS:Infants with prolonged transitional hypoglycaemia are predominantly male, SGA and have early severe/recurrent hypoglycaemia requiring glucose boluses and high glucose delivery rates in the first 24-48 h.
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