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Neonatal Hypoglycemia

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2. Follow-up study of neurodevelopment in 2-year-old infants who had suffered from neonatal hypoglycemia. (PubMed)

Follow-up study of neurodevelopment in 2-year-old infants who had suffered from neonatal hypoglycemia. Neonatal hypoglycemia is tightly related to adverse neurodevelopmental and brain injury outcomes.A total of 195 infants who were born from diabetic mothers with a low blood glucose level (< 2.6 mM) within 0.5 h after birth were enrolled in this prospective cohort study. Of these, 157 infants who had neonatal hypoglycemia (group A) were followed up, and this group was further divided into A1 (...)  ± 11.2; 71.5 ± 8.9 vs. 87.9 ± 11.2, respectively). There were significantly more mothers who used insulin during the perinatal period in A3 than in A1 and A2 (31% vs. 2%; 31% vs. 7.9%, respectively). The mothers of babies in subgroups A2 and A3 gained more weight than those of the control group (15.3 ± 1.9 kg vs. 11.1 ± 2.2 kg; 14.8 ± 2.6 kg vs. 11.1 ± 2.2 kg, respectively).Long and repeated neonatal hypoglycemia caused poor adaptability. The babies of mothers who used insulin or had a high weight

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2019 BMC Pediatrics

3. Guidelines for Blood Glucose Monitoring and Treatment of Hypoglycemia in Term and Late-Preterm Neonates

Guidelines for Blood Glucose Monitoring and Treatment of Hypoglycemia in Term and Late-Preterm Neonates ABM Protocol ABM Clinical Protocol #1: Guidelines for Blood Glucose Monitoring and Treatment of Hypoglycemia in Term and Late-Preterm Neonates, Revised 2014 Nancy Wight, 1,2 Kathleen A. Marinelli, 3,4 and The Academy of Breastfeeding Medicine A central goal of The Academy of Breastfeeding Medicine is the development of clinical protocols for managing (...) medicallynecessary supplementation forhypoglycemia or during separation of mother and baby Background Physiology The term ‘‘hypoglycemia’’ refers to a low blood glucose concentration. Clinically signi?cant neonatal hypoglycemia re?ects an imbalance between the supply and utilization of glucoseand alternativefuelsand mayresultfromseveral dis- turbedregulatorymechanisms. 1 Transienthypoglycemiainthe ?rsthoursafterbirthiscommon,occurringinalmostallmam- maliannewborns.Inhealthy,termhumaninfants,evenifearly enteral

2014 Academy of Breastfeeding Medicine

4. Moderate neonatal hypoglycemia and adverse neurological development at 2–6 years of age (PubMed)

Moderate neonatal hypoglycemia and adverse neurological development at 2–6 years of age To determine whether moderate neonatal hypoglycemia in otherwise healthy infants is associated with adverse neurodevelopmental outcome in pre-school children. Population-based cohort study with prospectively collected register data from Sweden. All singletons born July 1st 2008 through December 31st 2012 (n = 101,060) in the region were included. Infants with congenital malformations, infants treated (...) in neonatal intensive care unit, infants with inborn errors of metabolism and infants to mothers with diabetes were excluded. Infants were followed-up until 2014, at 2-6 years of age. Exposure was neonatal moderate hypoglycemia. Main outcomes were a compiled neurological or neurodevelopmental outcome; any developmental delay; motor developmental delay; and cognitive developmental delay. In adjusted regression analyses, the odds ratio (OR) of any neurological or neurodevelopmental outcome was 1.48 (95

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2018 European journal of epidemiology

5. Neonatal hypoglycemia: continuous glucose monitoring. (PubMed)

Neonatal hypoglycemia: continuous glucose monitoring. Continuous glucose monitoring (CGM) is increasingly used in the management of diabetes in children and adults, but there are few data regarding its use in neonates. The purpose of this article is to discuss the potential benefits and limitations of CGM in neonates.Smaller electrodes in new sensors and real-time monitoring have made CGM devices more approachable for neonatal care. CGM is well tolerated in infants including very low birth (...) weight babies, and few if any local complications have been reported. Use of CGM in newborns may reduce the frequency of blood sampling and improve glycemic stability, with more time spent in the euglycemic range. However, CGM may also lead to more intervention, with potential adverse effects on outcomes. More information is also needed about reliability, calibration and interpretation of CGM in the neonate.Although the use of CGM in neonates appears to be well tolerated, feasible and has been

2018 Current Opinion in Pediatrics

6. Prophylactic Dextrose Gel Does Not Prevent Neonatal Hypoglycemia: A Quasi-Experimental Pilot Study. (PubMed)

Prophylactic Dextrose Gel Does Not Prevent Neonatal Hypoglycemia: A Quasi-Experimental Pilot Study. To test the hypothesis that prophylactic dextrose gel administered to newborn infants at risk for hypoglycemia will increase the initial blood glucose concentration after the first feeding and decrease neonatal intensive care unit (NICU) admissions for treatment of asymptomatic neonatal hypoglycemia compared with feedings alone.This quasi-experimental study allocated asymptomatic at-risk newborn (...) ). Rates of NICU admission for treatment of transient neonatal hypoglycemia were 9.7% and 14.6%, respectively (P = .40).Prophylactic dextrose gel did not reduce transient neonatal hypoglycemia or NICU admissions for hypoglycemia. The carbohydrate concentration of Insta-Glucose (77%) may have caused a hyperinsulinemic response, or alternatively, exogenous enteral dextrose influences glucose homeostasis minimally during the first few hours when counter-regulatory mechanisms are especially

2018 Journal of Pediatrics

7. A Quality-Improvement Initiative to Reduce NICU Transfers for Neonates at Risk for Hypoglycemia. (PubMed)

A Quality-Improvement Initiative to Reduce NICU Transfers for Neonates at Risk for Hypoglycemia. Neonatal hypoglycemia is a common problem, often requiring management in the NICU. Nonpharmacologic interventions, including early breastfeeding and skin-to-skin care (SSC), may prevent hypoglycemia and the need to escalate care. Our objective was to maintain mother-infant dyads in the mother-infant unit by decreasing hypoglycemia resulting in NICU transfer.Inborn infants ≥35 weeks' gestation (...) with at least 1 risk factor for hypoglycemia were included. Using quality-improvement methodology, a bundle for at-risk infants was implemented, which included a protocol change focusing on early SSC, early feeding, and obtaining a blood glucose measurement in asymptomatic infants at 90 minutes. The primary outcome was the overall transfer rate of at-risk infants to the NICU. Secondary outcomes were related to protocol adherence. Balancing measures, including the rate of symptomatic hypoglycemia and sepsis

2018 Pediatrics

8. Neonatal Hypoglycemia Following Diet-Controlled and Insulin-Treated Gestational Diabetes Mellitus. (PubMed)

Neonatal Hypoglycemia Following Diet-Controlled and Insulin-Treated Gestational Diabetes Mellitus. To assess the risk of neonatal hypoglycemia following diet-controlled and insulin-treated gestational diabetes mellitus (GDM) and how it relates to birth weight.Prospective cohort study included term neonates born after GDM from January 2013 through December 2015 at the University Medical Center Utrecht (Utrecht, the Netherlands). Routine screening of neonatal blood glucose levels was performed (...) at 1, 3, 6, 12, and 24 h after birth. Main outcome measures were neonatal hypoglycemia defined as blood glucose ≤36 mg/dL (severe) and ≤47 mg/dL (mild).A total of 506 neonates were included, born after pregnancies complicated by GDM treated either with insulin (22.5%) or without insulin (77.5%). The incidence of mild and severe hypoglycemia was similar in the insulin-treated and diet-controlled groups (33 vs. 35%, P = 0.66; and 20 vs. 21%, P = 0.79). A birth weight >90th centile was seen in 17.2

2018 Diabetes Care

9. Cost Analysis of Treating Neonatal Hypoglycemia with Dextrose Gel. (PubMed)

Cost Analysis of Treating Neonatal Hypoglycemia with Dextrose Gel. To evaluate the costs of using dextrose gel as a primary treatment for neonatal hypoglycemia in the first 48 hours after birth compared with standard care.We used a decision tree to model overall costs, including those specific to hypoglycemia monitoring and treatment and those related to the infant's length of stay in the postnatal ward or neonatal intensive care unit, comparing the use of dextrose gel for treatment of neonatal (...) hypoglycemia with placebo, using data from the Sugar Babies randomized trial. Sensitivity analyses assessed the impact of dextrose gel cost, neonatal intensive care cost, cesarean delivery rate, and costs of glucose monitoring.In the primary analysis, treating neonatal hypoglycemia using dextrose gel had an overall cost of NZ$6863.81 and standard care (placebo) cost NZ$8178.25; a saving of NZ$1314.44 per infant treated. Sensitivity analyses showed that dextrose gel remained cost saving with wide variations

2018 Journal of Pediatrics

10. Antenatal Betamethasone and the Risk of Neonatal Hypoglycemia

Antenatal Betamethasone and the Risk of Neonatal Hypoglycemia Antenatal Betamethasone and the Risk of Neonatal Hypoglycemia - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more. Antenatal Betamethasone (...) and the Risk of Neonatal Hypoglycemia The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. of clinical studies and talk to your health care provider before participating. Read our for details. ClinicalTrials.gov Identifier: NCT03702959 Recruitment Status : Not yet recruiting First Posted : October 11, 2018 Last Update Posted : October 11, 2018 See Sponsor: Rambam

2018 Clinical Trials

11. Detecting Neonatal Hypoglycemia Using Real-Time Continuous Glucose Monitoring (CGM)

Detecting Neonatal Hypoglycemia Using Real-Time Continuous Glucose Monitoring (CGM) Detecting Neonatal Hypoglycemia Using Real-Time Continuous Glucose Monitoring (CGM) - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before (...) adding more. Detecting Neonatal Hypoglycemia Using Real-Time Continuous Glucose Monitoring (CGM) The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our for details. ClinicalTrials.gov Identifier: NCT03032523 Recruitment Status : Completed First Posted : January 26, 2017 Last Update Posted : May 25, 2018 Sponsor: Stanford University Information provided

2017 Clinical Trials

12. What Happens to Blood Glucose Concentrations After Oral Treatment for Neonatal Hypoglycemia? (PubMed)

What Happens to Blood Glucose Concentrations After Oral Treatment for Neonatal Hypoglycemia? To determine the change in blood glucose concentration after oral treatment of infants with hypoglycemia in the first 48 hours after birth.We analyzed data from 227 infants with hypoglycemia (blood glucose <46.8 mg/dL, 2.6 mmol/L) born at a tertiary hospital who experienced 295 episodes of hypoglycemia. Blood glucose concentrations were measured (glucose oxidase) within 90 minutes after randomization (...) ; P = .09) or expressed breast milk (-1.4 mg/dL; 95% CI -3.7 to 0.9; P = .25). However, breast feeding was associated with reduced requirement for repeat gel treatment (OR = 0.52; 95% CI 0.28-0.94; P = .03).Treatment of infants with hypoglycemia with dextrose gel or formula is associated with increased blood glucose concentration and breast feeding with reduced need for further treatment. Dextrose gel and breast feeding should be considered for first-line oral treatment of infants

2017 Journal of Pediatrics

13. Racial Differences in Neonatal Hypoglycemia among Very Early Preterm Births (PubMed)

Racial Differences in Neonatal Hypoglycemia among Very Early Preterm Births To determine whether the prevalence of neonatal hypoglycemia differs by race/ethnicity.A retrospective cohort study using prospectively collected data from 515 neonates born very preterm (<32 weeks) to normoglycemic women and admitted to the neonatal intensive care unit (NICU) at a major tertiary hospital in Boston, MA, between 2008 and 2012.A total of 61%, 12%, 7%, 7%, and 13% were White, Black, Hispanic, Asian (...) , and Other, respectively. Among the 66% spontaneous preterm births, 63% of the black neonates experienced hypoglycemia (blood glucose level < 40 mg/dL), while only 22-30% of the other racial/ethnic neonates did so (Black vs. White RR 2.15; 95% CI: 1.54-3.00). After adjusting for maternal education, maternal age, multiple gestations, delivery type, gestational age, birth weight, and neonates' sex, this association remained significant (adjusted Black vs. White RR: 1.61, 95% CI: 1.13-2.29). An increased

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2017 Journal of perinatology : official journal of the California Perinatal Association

14. C-Section Prevalence Among Obese Mothers and Neonatal Hypoglycemia: a Cohort Analysis of the Department of Gynecology and Obstetrics of the University of Lübeck (PubMed)

C-Section Prevalence Among Obese Mothers and Neonatal Hypoglycemia: a Cohort Analysis of the Department of Gynecology and Obstetrics of the University of Lübeck Data from the World Health Organization (WHO) demonstrates an increasing prevalence of obesity in Western countries. This study investigates the influence of obesity on the mode of delivery and the occurrence of hypoglycemia in newborns.A retrospective analysis of all deliveries at the Department of Gynecology and Obstetrics (...) ; obesity III° BMI ≥ 40 kg/m 2 , n = 212.Analysis of the primary outcome shows an increased incidence of non-elective C-sections with an elevated BMI (general obesity vs. control group: 20.5 vs. 15.9%, p < 0.001; OR 1.3; 95% CI 1.2 - 1.4) and elevated rates of neonatal hypoglycemia in newborns of obese mothers (general obesity vs. control group: 0.6 vs. 0.3%, p < 0.05; OR 1.8; 95% CI 1.0 - 3.0).Obesity is an essential obstetric risk factor. Obese women face an increased risk of non-elective C-sections

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2017 Geburtshilfe Und Frauenheilkunde

15. Effects of Skin-to-Skin Care on Late Preterm and Term Infants At-Risk for Neonatal Hypoglycemia (PubMed)

Effects of Skin-to-Skin Care on Late Preterm and Term Infants At-Risk for Neonatal Hypoglycemia The objective of this study was to evaluate the effects of prolonged skin-to-skin care (SSC) during blood glucose monitoring (12-24 hours) in late preterm and term infants at-risk for neonatal hypoglycemia (NH).We conducted a retrospective pre- and postintervention study. We compared late preterm and term infants at-risk for NH born in a 1-year period before the SSC intervention, May 1, 2013 (...) , to April 30, 2014 (pre-SSC) to at-risk infants born in the year following the implementation of SSC intervention, May 1, 2014, to April 30, 2015 (post-SSC).The number of hypoglycemia admissions to neonatal intensive care unit among at-risk infants for NH decreased significantly from 8.1% pre-SSC period to 3.5% post-SSC period (P = 0.018). The number of infants receiving intravenous dextrose bolus in the newborn nursery also decreased significantly from 5.9% to 2.1% (P = 0.02). Number of infants

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2017 Pediatric Quality & Safety

16. ASPEN Clinical Guidelines: Hyperglycemia and Hypoglycemia in the Neonate Receiving Parenteral Nutrition

ASPEN Clinical Guidelines: Hyperglycemia and Hypoglycemia in the Neonate Receiving Parenteral Nutrition 81 Journal of Parenteral and Enteral Nutrition Volume 36 Number 1 January 2012 81-95 © 2012 American Society for Parenteral and Enteral Nutrition 10.1177/0148607111418980 http://jpen.sagepub.com hosted at http://online.sagepub.com Background This Clinical Guideline has been developed to guide clinical practice based on the authors’ assessment of cur- rent published evidence on glycemic (...) control in the neo- nate (within the first month of life) receiving parenteral nutrition (PN). The neonate receiving PN is worthy of special consideration with respect to glucose control, as this population carries an elevated risk of hyper- and hypoglycemia and may be more susceptible to deleterious effects associated with these conditions. Untreated hyper- or hypoglycemia may lead to unde- sirable clinical outcomes. Prolonged or symptomatic hypoglycemia may result in neurodevelopmental impair- ment

2012 American Society for Parenteral and Enteral Nutrition

17. Oral Dextrose Gel Reduces the Need for Intravenous Dextrose Therapy in Neonatal Hypoglycemia (PubMed)

Oral Dextrose Gel Reduces the Need for Intravenous Dextrose Therapy in Neonatal Hypoglycemia Newborn infants with risk factors may require intravenous (IV) dextrose for asymptomatic hypoglycemia. Administration of IV dextrose and transfer to the neonatal intensive care unit (NICU) may interfere with parent-infant bonding.To study the effect of implementing dextrose gel supplement with feeds in late preterm/term infants affected by asymptomatic hypoglycemia on reducing IV dextrose therapy.A (...) compared to 144/248 (58%) with feeds only (p < 0.01). Transfer from the NBN to the NICU for IV dextrose decreased from 35/1,000 to 25/1,000 live births (p < 0.01). Exclusive breastfeeding improved from 19 to 28% (p = 0.03).Use of dextrose gel with feeds reduced the need for IV fluids, avoided separation from the mother and promoted breastfeeding. Neonates who failed dextrose gel therapy were more likely to be large for gestational age, delivered by cesarean section and had lower baseline blood glucose

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2016 Biomedicine hub

18. Evaluation of Blood Glucose Monitoring System in Screening for Neonatal Hypoglycemia: Tighter Accuracy Standard (PubMed)

Evaluation of Blood Glucose Monitoring System in Screening for Neonatal Hypoglycemia: Tighter Accuracy Standard Neonatal hypoglycemia may cause severe neurological damages; therefore, tight glycemic control is crucial to identify neonate at risk. Previous blood glucose monitoring system (BGMS) failed to perform well in neonates; there are calls for the tightening of accuracy requirements. It remains a need for accurate BGMS for effective bedside diabetes management in neonatal care within (...) a hospital population. A total of 300 neonates were recruited from local hospitals. Accuracy performance of a commercially available BGMS was evaluated against reference instrument in screening for neonatal hypoglycemia, and assessment was made based on the ISO15197:2013 and a tighter standard. At blood glucose level < 47 mg/dl, BGMS assessed met the minimal accuracy requirement of ISO 15197:2013 and tighter standard at 100% and 97.2%, respectively.

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2016 Journal of diabetes science and technology

19. Developmental Outcomes of Preterm Infants With Neonatal Hypoglycemia. (PubMed)

Developmental Outcomes of Preterm Infants With Neonatal Hypoglycemia. Neonatal hypoglycemia has been associated with abnormalities on brain imaging and a spectrum of developmental delays, although historical and recent studies show conflicting results. We compared the cognitive, academic, and behavioral outcomes of preterm infants with neonatal hypoglycemia with those of normoglycemic controls at 3 to 18 years of age.A secondary analysis of data from the Infant Health and Development Program (...) , gestational age, sex, severity of neonatal course, race, maternal education, and maternal preconception weight.No significant differences were observed in cognitive or academic skills between the control and effected groups at any age. Participants with more severe neonatal hypoglycemia reported fewer problem behaviors at age 18 than those without hypoglycemia.No significant differences in intellectual or academic achievement were found between preterm infants with and without hypoglycemia. A statistical

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2016 Pediatrics

20. Neonatal hypoglycemia. (PubMed)

Neonatal hypoglycemia. A consistent definition for neonatal hypoglycemia in the first 48 h of life continues to elude us. Enhanced understanding of metabolic disturbances and genetic disorders that underlie alterations in postnatal glucose homeostasis has added useful information to understanding transitional hypoglycemia. This growth in knowledge still has not led to what we need to know: "How low is too low and for how long?" This article reviews the current state of understanding of neonatal (...) hypoglycemia and how different approaches reach different "expert" opinions.Copyright © 2016 Elsevier Ltd. All rights reserved.

2016 Seminars in fetal & neonatal medicine

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