Frequency, Pattern, and Risk Factors of Hypoglycemia in Small for Gestational Age Neonates: A Prospective Single-center Study

Background: Hypoglycemia is a common problem among small for gestational age (SGA) neonates. It is associated with increased morbidity and mortality, thereby needing urgent monitoring of blood glucose levels avoiding poor long-term outcomes in these neonates. Objectives: The purpose of this study was to determine the frequency, clinical profile, pattern, and risk factors of hypoglycemia among SGA neonates. Materials and Methods: All the SGA neonates, born between 2022 and 2024 and admitted to the newborn stabilization unit (NBSU), were included. Heel-prick capillary blood glucose levels were screened with the help of an AccuSure glucometer at 0, 1, 2, 4, 6, 8, 12, and 24 h and every 6 h for 72 h of age to monitor hypoglycemia. Mode of feeding and symptoms of hypoglycemia were documented. Descriptive statistics, Chi-square test, and logistic regression analysis were used. Results: A total of 131 SGA neonates were included. Hypoglycemia occurred in 32.8% ( n = 43), with 25.2% ( n = 33) being symptomatic. The majority of the hypoglycemic episodes occurred within 6 h of birth. Of these, 89 (67.9%) neonates received feeding within 1 h of birth, and hypoglycemia was developed in only 17 (19.1%) SGA neonates ( P < 0.001). Between preterm and term SGA neonates, there was a statistically significant difference in hypoglycemic episodes. Logistic regression analysis revealed late initiation of feeding, late preterm, severe oligohydramnios, cesarean delivery, and very low birth weight, which were statistically significant risk factors for hypoglycemia ( P < 0.05). Conclusion: All SGA neonates should be screened for hypoglycemia for at least 48 h of life. Early initiation of breast milk feeding will reduce the frequency of hypoglycemia in SGA neonates.