Risk factors for transient neonatal hypoglycemia in term individuals, case and control study in a hospital of Bogotá
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Risk Factors

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Cristo Colmenares, J., Burbano Camacho, E., Ortiz, C., & Gómez Hoyos, D. (2021). Risk factors for transient neonatal hypoglycemia in term individuals, case and control study in a hospital of Bogotá. Revista Colombiana De Endocrinología, Diabetes &Amp; Metabolismo, 7(4), 286–293. https://doi.org/10.53853/encr.7.4.656


Introduction: Hypoglycemia in newborns is a frequent pathology, and it may present as transient or persistent. Many different cut-off points are used to define blood glucose, usually set at less than 47 mg/dL. There is evidence for both maternal and neonatal risk factors that increase the risk of developing the disease by 14.7% to 83.2%, as compared to 5% in patients without those risk factors. Likewise, it has been demonstrated that delay in the treatment of hypoglycemia is associated with neurodevelopmental alterations.

Objective: To determine the risk factors associated with transient neonatal hypoglycemia in term infants with no risk factors as defined by the American American Academy of Pediatrics guidelines, at Hospital Universitario Clínica San Rafael during the period between January, 2015 and January, 2019.

Methodology: Observational, analytical, retrospective case-control study conducted between January, 2015 and January, 2019. Sample calculation was performed and 35 cases and 35 controls were obtained using the Real Statistics software 6.9 of January, 2020.

Results: The highest proportion of patients in the study was female (61.43%), 20 cases and 23 controls. Average glucose level on admission of the cases was 40.8 mg/dL. Risk factors included maternal overweight with an odds ratio (OR) of 1.2; caesarean section, performed in 15 cases (42.8%), with an OR of 2.5; and pregnancy-induced hypertension, found in 4 cases and 1 control, with an OR of 4.38. There was evidence of a significant association with an Apgar score of 5 in the first minute in 3 cases (8.57%); the first energy intake by the newborn, with 25 (71.4%) of the cases receiving breastfeeding; transient tachypnea of the newborn (TTN) in 6 (17.14%) cases; and polycythemia in 10 (28.57%) cases, as neonatal variables, and skin-to-skin contact as a maternal variable in 7 cases (20%) that did not receive it.

Conclusions: In the term population considered healthy that developed transient neonatal hypoglycemia, an association was found with an Apgar score of 5 in the first minute, the first energy intake, TTN, polycythemia and skin-to-skin contact. The effects of variables that mostly influence metabolic glucose utilization can be seen in the long term in the motor skills and neurodevelopment of the population affected by this pathology. It is a wake-up call to be more vigilant of this group of newborns who, despite having a lower incidence of hypoglycemia, require surveillance and follow-up given the influence of various different factors.

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