Hypoglycemia Screening Before Discharge in Asymptomatic Newborns Identified as Being at Risk

Abstract

Objective: To assess the incidence and associated factors of hypoglycemia in asymptomatic at-risk infants at 48 to 60 hours of age, and to evaluate the reliability of point-of-care (POC) glucometers compared with standard plasma glucose methods. Materials and Methods: A prospective cohort study was conducted between July 2023 and May 2024 at a tertiary care hospital. Asymptomatic neonates aged 48 to 60 hours, with gestational ages between 34 and 41 weeks, identified as being at risk for hypoglycemia were enrolled. Blood glucose levels were measured using both a glucometer and a standard plasma glucose testing. Results: Among the 139 newborns included in the present study, the incidence of hypoglycemia was 10.8% when assessed using POC glucometers and 48.9% when measured with standard laboratory testing. Infants with discharged weights of 2,500 g or less were more than twice as likely to experience hypoglycemia (AOR 2.46, 95% CI 1.09 to 5.57). The mean glucose level obtained from POC glucometer measurements was 14.8 mg/dL higher than that obtained from laboratory measurement (95% CI 13.08 to 16.52). Conclusion: There is a high incidence of hypoglycemia among asymptomatic neonates identified as being at risk before discharge. Asymptomatic neonates with risk factors for hypoglycemia and a discharge weight of 2,500 g or less should be screened for hypoglycemia at 48 to 60 hours of age.