Asymptomatic hypoglycemia among preterm newborns: a cross-sectional analysis

Background Hypoglycemia is the commonest metabolic abnormality encountered in newborns. Preterm newborns are the group with the highest risk of clinically significant hypoglycemia. However exact factors associated with asymptomatic neonatal hypoglycemia is not known. Objective To assess factors associated with asymptomatic hypoglycemia among preterm newborns. Materials and Methods A cross sectional hospital analytical-based study was carried out at Dar es salaam public regional referral hospitals. Specifically, the study was done at Amana, Mwananyamala and Temeke. Data on demographic and clinical characteristics of preterm newborns and their mothers were collected and analyzed using Epi-Info™ software version 7.4. Main data analysis was done by applying a multivariable logistic regression model with neonatal random glycaemia coded in a binary fashion at a cut-off point of 2.6 mmol/L. An α-level of 5% was used as a limit of type I error. Results We recruited and analysed 217 asymptomatic preterm newborns within 6-24 hours post-delivery. Male: Female = 1.1:1 (females n=105, 48.4%). Median glycemic level was 2.6 (IQR; 2.1-3.9) mmol/L. Breastfeeding within 1st hour post-delivery was the only statistically significant protective factor against development of neonatal hypoglycemia (OR; 0.123, 95%-CI; 0.052-0.287) in a fitted multivariable logistic regression model. Conclusion Nearly half of all asymptomatic newborns were in hypoglycemic range. Delayed breast feeding within 1 st hour post-delivery was associated with neonatal hypoglycemia. Recommendations Breastfeeding practices within 1 st hour post-delivery need to be emphasized to all expectant mothers in order to avoid risk of asymptomatic neonatal hypoglycemia. Preterm neonates maybe the risky group worth considering for continuous glycemic screening at hospital protocols.