Prevalence of Hypoglycemia Among Preterm Infants in a Neonatal Intensive Care Unit: Cross-Sectional Study
DOI:
https://doi.org/10.65761/pjcr.2025.2.2.17Keywords:
Hypoglycemia; Infant, Premature; Intensive Care Units, Neonatal; Blood Glucose; Prevalence; PakistanAbstract
Background: Neonatal hypoglycemia is a critical and common metabolic disturbance among preterm infants that predisposes to significant neurodevelopmental impairment if not promptly diagnosed and treated. Although its importance is well recognized globally, localized prevalence data in tertiary care neonatal intensive care units (NICUs) in Pakistan remain limited. This study therefore aimed to determine the prevalence of hypoglycemia among preterm infants admitted to the Govt Children Hospital Mandi Bahauddin, Pakistan
Methods: A cross-sectional study was conducted from June 2024 to May 2025 in the Govt Children Hospital Mandi Bahauddin, Pakistan. Preterm infants with gestational age <37 weeks were consecutively enrolled. Blood glucose levels were monitored using standardized glucometer testing during the first 72 hours of life. Hypoglycemia was defined as a plasma glucose concentration <45 mg/dL (2.5 mmol/L). Data were collected on demographic characteristics, gestational age, birth weight, timing of hypoglycemic episodes, and presence of clinical symptoms. Descriptive statistics were used to calculate prevalence and stratify findings by gestational age and birth weight.
Findings: A total of 186 preterm infants were screened during the study period. Overall, 31.7% (n = 59) of the preterm cohort developed at least one episode of hypoglycemia, a prevalence consistent with similar NICU studies in Pakistan reporting rates between 30% and 43% among high-risk neonates. Among those with hypoglycemia, approximately 80% were identified through routine glucose monitoring before clinical signs manifested, while 20% exhibited symptoms such as feeding difficulty and jitteriness. Extremely preterm infants (gestational age <32 weeks) and those with very low birth weight (<1500 g) had significantly higher rates of hypoglycemic episodes compared with late preterm infants. The mean time to first hypoglycemic episode was approximately 6 hours post-delivery.
Conclusion: Hypoglycemia is highly prevalent among preterm infants admitted to the NICU in a tertiary care setting in Pakistan, affecting nearly one in three infants. A high proportion of cases were asymptomatic, underscoring the critical need for routine and rigorous glucose monitoring protocols in all preterm infants during the early postnatal period to prevent potential long-term neurological sequelae. Early identification and intervention strategies should be integrated into standard NICU care pathways.
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