Screening of Hypoglycaemia in Low Birth Weight Neonates Admitted in Postnatal Ward: A Prospective Cohort Study

Introduction: Low Birth Weight (LBW) neonates show minimal signs of hypoglycaemia, with immature compensatory mechanisms and nonspecific symptoms complicating the diagnosis. Both symptomatic and asymptomatic cases risk neurological damage, stressing the need for prompt detection and treatment. Aim: The aim of this study was to determine the incidence of hypoglycaemia in LBW neonates within the first 48 hours of life, assess mean glucose levels at the 1st, 24th, and 48th hours, identify etiological factors, and evaluate treatment response and immediate outcomes. Materials and Methods: This prospective cohort study was conducted at BJ Medical College and Civil Hospital, Ahmedabad, India, over a one-year period from January 2023 to December 2023. The study included 2,143 LBW neonates (birth weight between 1.8 kg and 2.5 kg) admitted to the postnatal ward. Blood glucose levels were screened at the 1st, 24th, and 48th hours of life. In neonates identified with hypoglycaemia, venous blood samples were collected and sent to the laboratory for confirmation. The Chi-square test was applied for comparison, and a p-value of <0.05 was considered statistically significant. Results: During the study, 2,143 neonates were screened, with a nearly equal male-to-female ratio: 1,080 (50.39%) were male and 1,063 (49.6%) were female. The mean gestational age was 37.5±1.18 weeks. The overall incidence of hypoglycaemia was 6.9%, significantly higher among preterm neonates, Small-for-Gestational-Age (SGA) infants, those with a birth weight below 2 kg, those receiving mixed feeding, those breastfed fewer than eight times in the first 24 hours, and those delivered via caesarean section. Most hypoglycemic episodes occurred within the first 24 hours after birth. Conclusion: In LBW neonates, hypoglycaemia was more commonly observed in preterm infants, those classified as SGA, those delivered by caesarean section, and those on mixed feeding. Inadequate breastfeeding was the most important cause, followed by sepsis, hypothermia, and polycythemia.