Decreasing early hypoglycemia frequency in at-risk newborns after implementing a new hypoglycemia screening algorithm

Muraleedharan Sivarajan, Joseph H. Schneider, Kathryn A Johnson, Shasha Bai, Nahed O. ElHassan, Jeffrey R. Kaiser, David B Nelson, Larry S. Brown, Patti J. Burchfield, Luc P. Brion

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Neonatal hypoglycemia may affect long-term neurodevelopment. Methods: Quality improvement (QI) initiative for Mother-Baby-Unit (MBU) admissions (birthweight ≥ 2100 g; ≥35 weeks’ gestation) over two epochs from 2016–2019 to reduce the frequency of early (≤3 h) neonatal hypoglycemia in small and large newborns. Intervention: New algorithm using Olsen’s growth curves, hypoglycemia thresholds of <2.22 mmol/L [40 mg/dL] (0–3 h) and <2.61 mmol/L [47 mg/dL] (>3 to 24 h), feeding optimization and 24-hour glucose checks for small for gestational age and preterm newborns. Results: Among 39,460 newborns, using subsets with identical screening criteria, early hypoglycemia decreased significantly after QI implementation among large for gestational age newborns with birthweight >3850 g (66%) and small for gestational age newborns with birthweight <2500 g (70%). Among all MBU admissions, the adjusted odds of any hypoglycemia in 24 h decreased (P < 0.001). Conclusions: Feeding optimization may decrease early hypoglycemia frequency in large and small newborns.

Original languageEnglish (US)
JournalJournal of Perinatology
DOIs
StateAccepted/In press - 2021

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology

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