Affiliations: [a] Department of Neonatology, Women wellness and Research Centre, Hamad Medical Corporation, Doha, State of Qatar
| [b] Department of Pediatrics, Weill Cornell Medical College, Doha, State of Qatar
| [c] Department of Nursing, Women wellness and Research Centre, Hamad Medical Corporation, Doha, State of Qatar
| [d] Department of Pharmacy Women wellness and Research Centre, Hamad Medical Corporation, Doha, State of Qatar
| [e] Department of Statistics, Hamad Medical Corporation Doha, State of Qatar
Correspondence:
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Address for correspondence: H. Parappil, MBBS, DCH,MD, FRCPCH. P.B No 3050. Consultant, Department of Neonatology, Women’s Wellness and Research Centre, Hamad Medical Corporation, Doha, Qatar. Tel.: +974 77661944; E-mail: drhussainparappil@gmail.com.
Abstract: BACKGROUND:Neonatal hypoglycemia is one of the most common causes of admission to neonatal intensive care unit requiring intravenous dextrose therapy. Administration of IV dextrose and transfer to the NICU may interfere with parent-infant bonding, breastfeeding, and has financial implications. OBJECTIVE:Retrospective study to evaluate the effect of dextrose gel supplementation for asymptomatic hypoglycemia in reducing NICU admissions and intravenous dextrose therapy. METHOD:A retrospective study conducted for eight months each before and after introduction of dextrose gel in the management of asymptomatic neonatal hypoglycemia. Asymptomatic hypoglycemic infants were given only feeds in pre dextrose gel period and dextrose gel along with feeds in the dextrose gel period. Rates of admission to NICU and the need of IV dextrose therapy were evaluated. RESULTS:High risk characteristics (Prematurity, Large for Gestational Age, small for Gestational Age, Infants of diabetic mother etc.) were equally distributed among both the cohorts. Primary outcome results showed significant reduction in NICU admissions from 396/1801(22%) to 329/1783 (18.5%) (odds ratio, 95% CI 1.24(1.05-1.46, p 0.008). There was significant reduction in IV dextrose therapy requirement from 277/1405 (15.4%) to 182/1454 (10.2%) (odds ratio, 95% CI 1.59(1.31- 1.95, p < 0.001).Babies discharged on predominant breast feeding showed significant improvement from 237/396(59.8%) in the pre dextrose gel period to 240/329 (72.9%) (odds ratio, 95% CI 0.82(0.73-0.90, p < 0.001) in dextrose gel period. CONCLUSIONS:Dextrose gel supplementation with feeds reduced NICU admissions, the need for parenteral dextrose therapy, avoided maternal separation and promoted breastfeeding.
Keywords: High risk neonates, parenteral dextrose therapy, transient asymptomatic hypoglycemia
