Hormozgan Med J. 2020 March; 24(1):e94453.
Published online 2020 March 1.
doi: 10.5812/hmj.94453.
Research Article
Prevalence of Hypoglycemia and Hypocalcemia Among High-Risk
Infants in the Neonatal Ward of Fatemieh Hospital of Hamadan in
2016 - 2017
Mohammad Kazem Sabzehei
1, *
, Marzieh Otogara
2, **
, Samira Ahmadi
2
, Fariba Daneshvar
2
,
Maryam Shabani
2
, Saeedeh Samavati
2
, Someyeh Hosseinirad
2
and Nasrin
Shirmohammadi-Khorram
3
1
Department of Pediatric, Faculty of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
2
Clinical Research Development Unit of Fatemieh Hospital, Hamadan University of Medical Sciences, Hamadan, Iran
3
Department of Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
*
Corresponding author: Hamadan University of Medical Sciences, Hamadan, Iran. Email: mk_sabzehei@yahoo.com
**
Corresponding author: Clinical Research Development Unit of Fatemieh Hospital, Hamadan University of Medical Sciences, Hamadan, Iran. Email: m_otogara@yahoo.com
Received 2019 May 25; Revised 2020 January 12; Accepted 2020 February 04.
Abstract
Background: Hypoglycemia and hypocalcemia are common metabolic disorders in high-risk infants that may cause serious com-
plications in case of late diagnosis.
Objectives: This study intended to determine the prevalence of hypoglycemia and hypocalcemia among high-risk infants.
Methods: A cross-sectional study was conducted on all the infants prone to hypoglycemia and hypocalcemia admitted to the neona-
tal ward of Fatemieh Hospital in Hamadan from September 2016 to October 2017. If infants’ blood glucose was less than 40 mg/dL
within the first four hours after birth and less than 45 mg/dL within 4 - 24 hours after birth, they were diagnosed with hypoglycemi.
If their blood calcium was less than 7 and 8 mg/dL in preterm and full-term infants, respectively, within 12 - 24 hours after birth, they
were diagnosed with hypocalcemia.
Results: A total of 883 infants participated in this study. The prevalence of hypoglycemia and hypocalcemia was 39.1% and 1.8%,
respectively. The mean birth weight was 2124.1 ± 272.8 g, and the gestational age was 35 ± 1.88 weeks. Hypoglycemia had a significant
relationship with preterm birth (P = 0.002), lower mean birth weight (P = 0.001), and low Apgar score at 1 and 5 minutes after birth
(P < 0.05). Hypocalcemia had a significant relationship with small for gestational age (SGA) (P = 0.007), lower mean birth weight (P
= 0.025), and low Apgar score at one and five minutes after birth (P < 0.05).
Conclusions: It is recommended to measure blood glucose and blood calcium in high-risk infants, including infants of diabetic
mothers (IDMs), preterm infants, and infants with lower birth weight (LBW), SGA, and low Apgar score at one and five minutes after
birth.
Keywords: Hypoglycemia, Hypocalcemia, Infants, Risk Factors
1. Background
Hypoglycemia is a common neonatal metabolic dis-
order that is more prevalent in high-risk infants includ-
ing IDMs, Small for gestational age (SGA) infants, asphyxia,
and preterm infants. Infants with hypoglycemia are often
asymptomatic or have nonspecific symptoms that are dif-
ficult to diagnose.
The plasma glucose level in the umbilical vein consists
of 80% of mothers’ blood sugar. After cutting the umbili-
cal cord, the transfer of glucose and other nutrients to the
infant suddenly stops. Subsequently, glucose drops to its
nadir level in infants within 1 - 3 hours after birth, however,
it spontaneously increases and reaches a steady state 3 - 4
hours after birth (1-5).
Hypoglycemia may be considered a metabolic disorder
associated with many severe neonatal diseases. Glycogen
depletion, impaired gluconeogenesis, and increased pe-
ripheral use of glucose may also be among the risk factors
for hypoglycemia. There is no consensus about the long-
term complications caused by transient hypoglycemia.
However, severe recurrent hypoglycemia may cause sus-
tained neurological problems such as seizures and mental
retardation (6-9).
Calcium is one of the body electrolytes that plays a
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