Early neonatal hypoglycemia: incidence of and risk factors. A cohort study using universal point of care screening
Early neonatal hypoglycemia: incidence of and risk factors. A cohort study using universal point of care screening
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DOI：
10.1080/14767058.2017.1391781
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发表时间：
2019-03-04
影响因子：
1.8
通讯作者：
Levy-Khademi, Floris
中科院分区：
文献类型：
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作者：
Bromiker, Ruben;Perry, Assaf;Levy-Khademi, Floris
目的：本研究的目的是确定早期新生儿低血糖的真实发生率并确认潜在的危险因素。研究设计：该研究于 2014 年 6 月至 9 月在以色列三级医疗中心进行。使用“护理点”分析仪 (Accu-Chek) 测量了进入托儿所的所有婴儿的首次血糖浓度。我们记录了低血糖的危险因素，如出生体重、胎龄、孕产妇糖尿病和人口统计数据，并分析了它们与两个低血糖临界值（40 和 47 mg/dl）的关联。结果：在此期间收治的 4000 名新生儿中，排除了 405 名缺失数据的新生儿后，对 3595 名进行了分析。血糖水平是在平均年龄 74 +/- 30 分钟时获得的。 124 名新生儿 (3.4%) 的血糖水平低于 40 mg/dl，435 名新生儿 (12.1%) 的血糖水平低于 47 mg/dl。单变量分析显示，胎龄、孕产妇糖尿病、低出生体重（3800 克）均不受影响。在多变量分析中，胎龄仍然是最强的关联，而母亲糖尿病和低出生体重变得不显着。结论：我们通过普遍筛查发现正常新生儿早期低血糖的发生率很高。最强的危险因素是早孕龄。令人惊讶的是，在存在其他经典危险因素的情况下，早期低血糖的发生率与普通人群相似。
Objective: The objective of this study is to determine the true incidence of early neonatal hypoglycemia and to confirm potential risk factors. Study design: The study was conducted at tertiary Medical Center in Israel, between June and September 2014. First blood glucose concentrations of all infants admitted to the nursery were measured using a "point of care" analyzer (Accu-Chek). We recorded risk factors for hypoglycemia such as birth weight, gestational age, maternal diabetes and demographics and analyzed their association with two hypoglycemia cutoffs: 40 and 47 mg/dl. Results: Of 4000 newborns admitted during that period, 3595 were analyzed after excluding 405 who had missing data. Glucose level was obtained at a mean age of 74 +/- 30 min. One hundred and twenty-four newborns (3.4%) had blood glucose levels below 40 mg/dl and 435 (12.1%) below 47 mg/dl. Univariate analyses revealed that gestational age, maternal diabetes, low birth weight (3800 g) were not. In multivariate analysis, gestational age remained the strongest association, while maternal diabetes and low birth weight became non-significant. Conclusions: We showed a high occurrence of early hypoglycemia in normal newborns using universal screening. The strongest risk factor was early gestational age. Surprisingly, incidence of early hypoglycemia in the presence of other classical risk factors was like that of the general population.