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Am J Perinatol 2021; 38(05): 490-496
DOI: 10.1055/s-0039-1698834
Original Article

Glucose Levels during the First 24 Hours following Perinatal Hypoxia

Mahdi Alsaleem
1   Department of Pediatrics, Children’s Mercy Hospital, University of Missouri-Kansas City School of Medicine, Missouri
,
Lida I. Zeinali
2   Department of Pediatrics, University at Buffalo, The State University of New York, Buffalo, New York
,
Bobby Mathew
2   Department of Pediatrics, University at Buffalo, The State University of New York, Buffalo, New York
,
Vasantha H.S. Kumar 
2   Department of Pediatrics, University at Buffalo, The State University of New York, Buffalo, New York
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Abstract

Objective Hypoglycemia is a significant risk factor for perinatal brain injury and adverse outcomes, particularly in infants requiring resuscitation following hypoxic ischemic (HI) insult. We aimed to study blood glucose (BG) levels in physiologically stressed infants in the presence or absence of epinephrine (Epi) administration at resuscitation in the first 24 hours after birth.

Study Design A retrospective chart review of all infants with heart rate (HR) < 100/min at 1 minute requiring positive pressure ventilation (PPV) at birth was performed. Infants were classified into two groups as follows: (1) PPV group: infants' HR improved with PPV only at resuscitation, and Epi group: infants received Epi at resuscitation for persistent bradycardia. Serial measurements of BG levels collected and glucose infusion rate (GIR) calculated at 24 hours.

Results By design, infants in the Epi group had lower cord pH and higher base deficit. BG was significantly lower overtime in premature infants ≤32 weeks of gestation in the Epi group. The BG was markedly higher in near-term and term infants in the Epi group compared with the PPV group. Hypoglycemia was more common despite administration of higher GIR in premature infants ≤32 weeks of gestation.

Conclusion In the presence of physiological stress, premature infants are more at risk for hypoglycemia than term infants.

Keywords

hyperglycemia - epinephrine - asphyxia - resuscitation - hypoglycemia - newborns


Publication History

Received: 23 May 2019

Accepted: 06 September 2019

Article published online:
04 November 2019

© 2019. Thieme. All rights reserved.

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