TITLE:
Clinical and Epidemiological Features and Management of Neonatal Hypoglycemia at the University Teaching Hospital of Treichville (Abidjan-Côte d’Ivoire)
AUTHORS:
Gneneyeri Joseph Ouattara, Lassina Cissé, Gervais Koffi, Jean-Jacques Atteby Yao, Jacob Enoh, Corinne Sei, Soumahoro Oulai
KEYWORDS:
Hypoglycaemia, Newborn, Prevalence, Emergency
JOURNAL NAME:
Open Journal of Pediatrics,
Vol.7 No.4,
December
12,
2017
ABSTRACT: The purpose of this study is to determine the
prevalence, the characteristics of hypoglycaemia in the newborn admitted to
emergency departments of teaching Hospital
of Treichville, Abidjan and to evaluate the relevance of capillary blood glucose in this diagnosis. Patients and
Methods: This prospective cross-sectional study was held from 01 February to 25 June 2017 in the Pediatric Emergency Department. It involved 201 newborns under 24 hours of age who consulted in
pediatric emergency for any reason. Data were collected from parent direct
interviews, analysis of the follow-up record, physical examination of the newborn, results of glucose level in the capillary
blood at heel and in venous blood. On
dry tube and gray tube (containing sodium fluoride and potassium oxalate),
the blood glucose on the latter tube constituting the reference blood glucose, with
neonatal hypoglycaemia defined by a venous blood glucose less than or equal to
2.5 mmol/l (0.45 g/l). The statistical tests used were the frequency
comparison, the Chi Square, the Fisher Test with a significance threshold p
0.05 or the Odds-ratio with a confidence interval of
95% and a significance threshold of 5%, but also with the correlation
coefficient. Results: Newborns of less
than 3 hours of life (70.6%) were the most represented with a male predominance (sex ratio = 2.9). The reasons for
consultation were dominated by neurological
disorders (36.5%), prematurity (31.8%), and fever (22.2%). The average time to complete the blood glucose test was
less than one hour after the sampling in 6.5% of the cases. The mean
blood glucose was 0.59 g/l (3.28 mmol/l) with extremes ranging from 0.15 to 1.8
g/l (0.83 mmol/l to 10 mmol/l). The
prevalence of hypoglycemia by the instantaneous glycemic method was 15.9%. On tube containing sodium fluoride and potassium
oxalate, it was 20.4%, while the prevalence of red blood cell hypoglycemia
was 38.1%. A good correlation was found between capillary glycemia and gray
tube with r = 0.97. Signs associated with hypoglycemia were predominantly male
(p 0.05), prematurity (p 0.05).
As for cerebral suffering, it had proved to be a protective factor (Fisher: 0.002). The mortality rate was 2.5%. Hypoglycemia was not found. Conclusion: Hypoglycaemia is relatively common in our working
setting, particularly in premature infants. However, it should be carefully
sought in any newborn admitted to emergency regardless of the
reason for admission. The use of capillary blood glucose proves to be a good
alternative because it allows a fast management.