Prevalence and risk factor of asymptomatic hypoglycemia in newborn at risk

Abstract

Background: Neonatal hypoglycemia is a common clinical condition that can lead to significant neurological impairment and long-term developmental delays. A critical challenge is that many affected neonates remain asymptomatic, which may lead to missed diagnoses and delayed intervention. Therefore, implementing appropriate and timely blood glucose screening in high-risk infants is essential to ensure prompt management and minimize potential brain injury.

Objective: To determine the prevalence and associated factors of asymptomatic hypoglycemia in at-risk infants.

Method: This retrospective observational study reviewed medical records of 227 newborns at risk of hypoglycemia including infants of diabetic mothers, late preterm infant, low birth weight and macrosomia at Chiangrai Prachanukroh Hospital between January 1, 2024 and December 31, 2024. Blood glucose was measured by heel-prick glucometer at four time points and plasma glucose was obtained for confirmation when values were low. Associated risk factors were identified using multiple logistic regression; capillary-plasma glucose agreement was assessed by Pearson's correlation.

Results: The prevalence of neonatal hypoglycemia was 8.8 among at-risk infants. Associated risk factors included maternal diabetes requiring insulin therapy (p value < 0.05) and meconium-stained amniotic fluid (p value < 0.05).

Conclusion: Asymptomatic hypoglycemia is prevalent among at-risk neonates. Systematic screening is recommended for all at-risk newborns to enable timely detection and management.