Risk Factors Analyse And Prevention Strategy Of Neonatal Hypoglycemia

BackgroundWith the rapid development of perinatology in the former years, the survival rate of neonate have high risks, including extremely low birth weight, has improved greatly, but the disability rate of neonatal neuro-development hasn't declined greatly, long-term neural sequel constitutes a major personal burden for affected individuals and their families and poses a considerable socioeconomic problem. As we known, high risks which may cause abnormal neural development include serious asphyxia, serious intracranial hemorrhages, moderate and serious hyperbilirubinemia, nervous system infection, persistent and repeating hypoglycemia, preterm infant and so on. However neonatal hypoglycemia is the most common metabolic disease, the clinical manifestation is not always typical, and at the same time neonatal hypoglycemia is the complication of other diseases, so most doctors may not think highly of neonatal hypoglycemia in clinical work. At present most people think that a great mount of healthy neonate show transient hypoglycemia may not cause serious brain injuries, but persistent and repeating neonatal hypoglycemia may bring neural sequel, such as cognition disorders, vision disorders, epilepsy, cerebral palsy. However until now research about high risks and neural development of neonatal hypoglycemia are very rare. Objectives1. To analyze high risks of non-diabetic mother neonatal hypoglycemia, in order to provide clinical evidences for preventing neonatal hypoglycemia and avoid hypoglycemic brain injuries.2. To understand neural development of non-diabetic mother hypoglycemic neonate.Methods111 cases of non-diabetic mother neonatal hypoglycemia came from Anhui Provincal Children's Hospital between 2009 January and 2010 March enrolled in this study, and 111 controls of normal blood glucose neonate at the same period in this hospital enrolled in too. And collect the information of these neonates, including basic information on admission ( datas of mother in perinatal period, birth history, past history and family history and so on), minimum and duration of hypoglycemia after admission, clinical manifestation, complication and neural development. Then analyze risk factors of neonatal hypoglycemia and understand neural development of non-diabetic mother hypoglycemic neonate in their one year's.Results1. The numbers of low birth weight, small for gestation age and day age below 3 days(P<0.05) are all larger than the numbers of controls; the numbers of mother with pregnancy-induced hypertension and mother's age below 25 years are lager(P<0.05) than the numbers of controls; the numbers of congenital heart disease(P<0.05) are lager than the numbers of controls.2. According to bivariant correlation analyse, it shows that lager the age of these hypoglycemic neonate on admission is, lower the blood glucose is, longer the duration of hypoglycemia is.3. Follow ups: to evaluate 22 hypoglycemic neonate in their one year's in hospital by development quotient, 14 infants showed motor disorders and intelligent disorders; 8 infants didn't show brain injuries. To compare infants with abnormal and normal neuro-development, it shows the rate of full term infants who have caused hypoglycemic brain injuries is high; the occurrence of hypoglycemic brain injures is correlated closely with minimum and duration of hypoglycemia. To follow up other hypoglycemic neonate in their one year's by telephone, 55 parents told that their infants were normal, but 4 parents told that the development of their infants was later than the development of normal infants in the same age. Besides there are 20 hypoglycemic neonates can't be followed up because of change of telephone number or address.Conclusions1. The neonates with low birth weight, small for gestation age, day age below 3 days, congenital heart disease, mother get pregnancy-induced hypertension and mother's age below 25 years are easier to cause hypoglycemia.2. The day age of hypoglycemic neonates on admission is correlated closely with the minimum and duration of hypoglycemia.3. Full-term infants may be easier to show up hypoglycemic brain injuries than preterm infants; the occurrence of hypoglycemic brain injuries correlates with minimum and duration of hypoglycemia.