Prevalence, risk factors, and outcome of hospitalization of neonatal hyperglycemia at a Nigerian health facility.

BACKGROUND

Neonatal hyperglycemia (NNH) like hypoglycemia is a dangerous metabolic disorder often associated with adverse consequences, if undetected and untreated. This study was set out to determine the prevalence, risk factors, and outcomes of babies with the point of admission hyperglycaemia at the Wesley Guild Hospital (WGH), Ilesa.

METHODS

The study was descriptive and cross-sectional, involving 300 consecutively recruited neonates admitted into the special care baby unit (SCBU) of the hospital. All subjects had blood glucose done at the point of admission using Accu-Chek Active® glucometer (Roche Diagnostics GmbH, Germany). Hyperglycemia was defined as blood glucose ≥7.0 mmol/L. Factors associated with NNH were determined using univariate and multivariate analyses.

RESULTS

Of the 300 subjects (Male: Female 1.5:1), there were 74 (24.7%) preterms, 35 (11.7%) small-for-gestational age and 85 (28.3%) low-birth-weight babies. Eighteen (6.0%) babies had hyperglycemia. Parental low socioeconomic class, maternal lack of antenatal care (ANC), vaginal delivery, grand multiparity, outborn status, respiratory distress, probable sepsis, and neonatal anemia at presentation were associated with NNH (P < 0.05). Respiratory distress (OR = 3.800, 95% CI = 1.122-12.873, P = 0.032), and probable sepsis (OR = 4.090, 95% CI = 1.206-13.872, P = 0.024) were independent predictors of hyperglycemia. Hyperglycemia was significantly associated with mortality. (38.9% vs. 11.0%; P = 0.001).

CONCLUSION

Neonatal hyperglycemia was detected in 6.0% of neonatal admission at the WGH, Ilesa and it was associated with increased mortality. Hyperglycemia should be suspected and promptly managed at the point of admission of ill newborns particularly those with respiratory distress and signs of sepsis.