Faryad Hussain, Husnul Hayat, Arif Zaheer, Agha Shabbir Ali.
Frequency and Clinical Manifestation of Hypoglycemia in Neonates in First 24 Hours Presenting in Neonatology Department, Lahore General Hospital Lahore.
Pak Paed J Jan ;42(1):48-54.

Objective: The objective of the study was to determine the frequency and clinical manifestation of hypoglycemia in the first 24hours in neonates presenting to a tertiary care centre Postgraduate Medical Institute/Lahore General Hospital, Lahore Setting: This study was conducted on 272 newborns admitted at Department of Neonatology Lahore General Hospital, Lahore. Methodology: A total of 272 both out born and inborn neonates admitted to Department of Neonatology, at Lahore General Hospital, Lahore were included in the study. A thorough history and clinical examination was done. The patients were assessed for the clinical features of neonatal hypoglycemia. Blood samples were drawn for serum blood glucose level. A blood glucose level of < 40 mg/dL was labeled as hypoglycemia. Results: The mean age of the newborns was 9.97 ± 6.67 hours. There were 93 (34.2%) female patients and 179 (65.8%) patients were male. The female to male ratio was 1:1.92. Neonatal hypoglycemia was observed in 85 (31.3%) patients. 46 out of 88 (52.3%) preterm were hypoglycemic, 35 out of 172 (20.3%) term babies were hypoglycemic and 4 out of 12 (33.3%) post-term babies were hypoglycemic. Frequency of hypoglycemic was 48.9% in small for gestational age (SGA) babies, 20.6% in appropriate for gestational age (AGA) and 31.2% in large for gestational age (LGA) babies. The mothers of 40 (14.7%) newborns were known diabetic and of 65 (23.9%) were hypertensive. Difficulty with feeding was seen in 77 (90.5%) newborns, listlessness in 59 (69.4%) newborns, jitteriness in 49 (57.6%) newborns, respiratory distress in 32 (37.6%) newborns, irritability in 25 (29.4%) newborns, hypothermia in 23 (27.1%) newborns, cyanosis in 22 (25%) neonates, lack of muscle tone in 21 (24.7%) newborns, weak or high pitch cry in 19 (22.3%) newborns, seizures in 16 (18.8%) newborns, apnea in 8 (9.4%) newborns, cardiorespiratory arrest in 2 (2.3%) newborns, pallor in 2 (2.3%) newborns and sweating in 1 (1.1%) newborn. Eight (9.4%) newborns were asymptomatic. Conclusion: Neonatal hypoglycemia is common among newborns in first 24 hours. Difficulty with feeding and listlessness were the two common clinical features. It is recommended that all high risk newborn should be screened for neonatal hypoglycemia.

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