Frequency of Asymptomatic Hypoglycemia in Full-Term Neonates Within the First Hour of Life

Background Hypoglycemia is a common metabolic abnormality in newborns. While short episodes of hypoglycemia in these infants are generally harmless, extended periods of hypoglycemia can lead to fatal outcomes. Early detection through readily available, routine testing and prompt management can prevent long-term disability and mortality in these children. Objective To determine the frequency and risk factors of hypoglycemia in asymptomatic, full-term neonates within the first hour of life. Methods This cross-sectional study was carried out in the Department of Pediatrics at Hayatabad Medical Complex, Peshawar, Pakistan. A total of 151 asymptomatic neonates with gestational age between 37 and 42 weeks were enrolled using a consecutive sampling technique. At-risk neonates such as those with a history of intrauterine growth retardation or birth asphyxia and those with a maternal history of premature rupture of membranes or gestational diabetes mellitus were excluded from the study. The neonates were screened within one hour of birth by the heel prick method, and hypoglycemia was defined as a blood glucose level of less than 47 milligrams per deciliter. In addition, gestational age, gender, birth weight, the mode of delivery, parity of the mother, and delay in breastfeeding for more than 30 minutes were noted. Data were analyzed in SPSS v. 22 (IBM Corp., Armonk, NY). Results The overall frequency of hypoglycemia was 15.2% (n = 23). Neonates with hypoglycemia had a significantly lower mean birth weight than those without hypoglycemia (2.7 ± 0.3 kg vs 2.9 ± 0.3 kg, p = 0.001). Univariate analysis identified low birth weight (p = 0.031), primiparity (p = 0.020), and delayed breastfeeding (p = 0.007) as factors associated with hypoglycemia. Multivariate analysis confirmed that low birth weight (AOR 5.5, 95% CI 1.2-26.3, p = 0.032) and delayed breastfeeding (AOR 3.3, 95% CI 1.1-9.5, p = 0.031) were independent risk factors for neonatal hypoglycemia. Primiparity did not maintain statistical significance after adjusting for other risk factors. Gender, gestational age, and mode of delivery were not significantly associated with the development of hypoglycemia. Conclusion The frequency of hypoglycemia in asymptomatic, full-term neonates was 15.2%. Low birth weight and delayed breastfeeding are significant independent risk factors for hypoglycemia in this population. Antenatal counseling and early skin-to-skin contact between mother and baby to promote early breastfeeding, and targeted screening of high-risk babies will have a positive impact.