Journal of perinatology : official journal of the California Perinatal Association · 2021
Decreasing early hypoglycemia frequency in at-risk newborns after implementing a new hypoglycemia screening algorithm.
СтатьяНазвание и аннотация: Перевод в очереди
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Sivarajan Muraleedharan, Schneider Joseph H, Johnson Kathryn A, Bai Shasha, ElHassan Nahed O, Kaiser Jeffrey R, Nelson David B, Brown Larry S, Burchfield Patti J, Brion Luc P
Аннотация
BACKGROUND: Neonatal hypoglycemia may affect long-term neurodevelopment.
METHODS: Quality improvement (QI) initiative for Mother-Baby-Unit (MBU) admissions (birthweight ≥ 2100 g; ≥35 weeks' gestation) over two epochs from 2016-2019 to reduce the frequency of early (≤3 h) neonatal hypoglycemia in small and large newborns.
INTERVENTION: New algorithm using Olsen's growth curves, hypoglycemia thresholds of <2.22 mmol/L [40 mg/dL] (0-3 h) and <2.61 mmol/L [47 mg/dL] (>3 to 24 h), feeding optimization and 24-hour glucose checks for small for gestational age and preterm newborns.
RESULTS: Among 39,460 newborns, using subsets with identical screening criteria, early hypoglycemia decreased significantly after QI implementation among large for gestational age newborns with birthweight >3850 g (66%) and small for gestational age newborns with birthweight <2500 g (70%). Among all MBU admissions, the adjusted odds of any hypoglycemia in 24 h decreased (P < 0.001).
CONCLUSIONS: Feeding optimization may decrease early hypoglycemia frequency in large and small newborns.
METHODS: Quality improvement (QI) initiative for Mother-Baby-Unit (MBU) admissions (birthweight ≥ 2100 g; ≥35 weeks' gestation) over two epochs from 2016-2019 to reduce the frequency of early (≤3 h) neonatal hypoglycemia in small and large newborns.
INTERVENTION: New algorithm using Olsen's growth curves, hypoglycemia thresholds of <2.22 mmol/L [40 mg/dL] (0-3 h) and <2.61 mmol/L [47 mg/dL] (>3 to 24 h), feeding optimization and 24-hour glucose checks for small for gestational age and preterm newborns.
RESULTS: Among 39,460 newborns, using subsets with identical screening criteria, early hypoglycemia decreased significantly after QI implementation among large for gestational age newborns with birthweight >3850 g (66%) and small for gestational age newborns with birthweight <2500 g (70%). Among all MBU admissions, the adjusted odds of any hypoglycemia in 24 h decreased (P < 0.001).
CONCLUSIONS: Feeding optimization may decrease early hypoglycemia frequency in large and small newborns.