Prevalence of hyperglycaemia in neonates admitted to the newborn unit at Kenyatta National Hospital

Abstract

Objective: To determine the prevalence of hyperglycaemia and identify associated risk factors for the development of hyperglycaemia in neonates admitted in the Newborn Unit, Kenyatta National Hospital.
Methods: Neonates admitted into the unit during the study period were recruited and information regarding birth weight, gestational age, co-morbidities including neonatal sepsis, asphyxia and hyper-bilirubinaemia was obtained. Plasma glucose measurements were taken every 8 hours for the first 3 days of life then twice daily for the next 2 days. Samples were obtained by heel pricks and analysed using the Hemocue® glucose analyser. Any glucose measure >8.3mmol/l was considered a hyperglycaemic value.
Results: We enrolled 93 neonates of whom 49 (46.2%) were noted to have hyperglycaemia. The mean gestational age of the neonates was 34 weeks ± 5 SD and 54 (58%) of the neonates weighed 2.5kg and more. The use of intravenous dextrose infusions was significantly associated with hyperglycaemia (CI 95%, p= 0.02 OR= 3.28). Hyperglycaemia was noted to increase with decreasing birth weight and was found to be an independent predictor of mortality among the neonates within the first 5 days of life (OR= 4.80; 95% CI = 1.98 – 11.63, p<0.001).
Conclusion: The prevalence of hyperglycaemia was high (46.2%) with intravenous dextrose infusions a contributing factor. The findings of this study prompt the need to carefully administer dextrose infusions at rates that mimic normal physiologic output and to routinely monitor plasma glucose levels in neonates.