Neonatal hypoglycaemia: prevalence and clinical manifestations in Port Harcourt, Nigeria

Abstract

Background: Neonatal hypoglycaemia is associated with significant long term neuro-developmental sequelae. The signs and symptoms are often non-specific. Some are completely asymptomatic. Many cases therefore remain undiagnosed. This study was therefore designed to determine the prevalence, obstetric and peri-natal factors associated with neonatal hypoglycaemia at the University of Port Harcourt Teaching Hospital, Nigeria.
Methods: All neonates delivered between 1st January and 31st May 2006 were recruited. Cord blood specimen was obtained from the placental end of the cord at delivery and assayed for plasma glucose. Relevant obstetric and neonatal data were obtained for each subject. Hypoglycaemia was defined as cord blood glucose level ≤ 2.2 mmol/L.
Results: Three hundred and four neonates were recruited. Of this number, 86 were hypoglycaemic giving a prevalence of 28.3%. Out of the 86, 43(50%) were symptomatic while 43(50%) were asymptomatic. The commonest symptoms were respiratory distress (46.5%), cyanosis (20.9%) and lethargy (18.6%). The mean cord plasma glucose for the symptomatic group (1.99+ 0.11 mmol/L) was significantly lower than that of the asymptomatic group (2.07+ 0.06 mmol/L) (p<0.05). The commonest obstetric and perinatal factors associated with hypoglycaemia were Caesarian section (43.0%), pre-term delivery (29.1%), low birth weight (27.9%), small for gestational age (18.6%), pre-eclampsia (15.1%) and prolonged obstructed labour (11.6%). The lowest plasma glucose levels were seen in pre-term babies (1.98+ 1.51 mmol/L) and small for gestational age babies (1.99+ 1.52 mmol/L).
Conclusion: Neonatal hypoglycaemia is still a common clinical problem. Because of associated long-term neuro-developmental sequelae, the need for routine screening and early intervention is advocated.


Keywords: Neonatal hypoglycaemia; Clinical manifestations

PHMJ Vol. 2 (2) 2008: pp. 166-170