Gynecology & Obstetrics
Open Access
ISSN: 2161-0932
ISSN: 2161-0932
Jameel Al Ghamdi, Niels Rochow, Michael Marrin, Naveed Durrani and Salhab el Helou
McMaster University, Canada
Albaha University, Saudi Arabia
Scientific Tracks Abstracts: Gynecol Obstet
Introduction: Neonatal hypoglycemia is a risk factor for neurological impairment. We routinely screen newborns for hypoglycemia based on risk factors, including: SGA or LGA, maternal use of a �²-blocker or insulin. In 2014 we detected hypoglycemia (<2.6 mmol/L) in 2 apparently healthy newborns with umbilical cord acidosis (pH < 7 or BE â�¤ -12mmol/L) McMaster children hospital hypoglycemia protocol does not include the population of healthy newborns with cord acidosis. Objective: To determine the occurrence of hypoglycemia in healthy newborns at birth but have umbilical cord acidosis. Method: We conducted a two-phase retrospective study at McMaster Childrenâ��s Hospital (MCH), Hamilton, ON during Oct. 2013 to Sept. 2014. Phase 1: retrospective study investigating the cord gas of infants admitted to the NICU or Level 2 Nursery due to hypoglycemia. Phase 2: retrospective examination of blood glucose concentrations in apparently healthy infants born at MCH who had a cord pH < 7 or BE â�¤ -12mmol/L. Exclusion criteria were being SGA or LGA, or born to mother with �²-blocker or insulin dependent diabetes. Results: Phase I: 160 newborns with hypoglycemia were admitted to NICU. 13 out of 18 infants with mild perinatal depression had further risk factors (5 Insulin dependent diabetes mother, 2 gestational diabetes, 1 LGA, 2 SGA, 1 mother on labetalol, 1 asphyxia, 1 sepsis). Five infants had hypoglycemia with no other risk factor had gestational age between 37- 41+1weeks, birth weight between 2552 â�� 3925g, UA pH 6.9-7.1 BE -16 to -10, UV pH 6.9-7.2 BE -16 to -11 with first blood glucose between 0.4 -2.1mmol/L measured at 2 to 6 hr of life. All 5 infants required IV dextrose to maintain blood for 2-4 days and length of stay 4-9 days. Phase 2 :166/2423 term infants met the cord gas criteria. Of these 57 had blood glucose determinations, 22 had a blood glucose <2.6 mmol/L. Hypoglycemia was recognized at a median age of 2 (2; 4) hours. Last blood glucose below 2.6mmol/L was measured up to 3 days, 8 (4; 12) hours. Four infants had hypoglycemia persisting for longer than 36 hours. Conclusion: Apparently healthy newborns with cord acidosis may at risk for hypoglycemia. Because not all infants with a cord acidosis had blood sugar determinations, we cannot estimate the degree of risk. Based on the above a prospective study comparing the blood glucose profile of apparently healthy with cord acidosis is recommended.
Jameel M Alghamdi gained his Bachelor Degree of Medicine and Surgery from King Khalid University in 2005. He has received Saudi and Arab Board in Pediatrics in 2012 and Neonatal- Perinatal medicine fellowship from McMaster University, Canada in 2016.