P2C332: Outcomes of Infants Screened for Hypoglycemia in the Mother Baby Unit and Risk Factors Associated with Admission to the Neonatal Intensive Care Unit

Background: Risk factors for hypoglycemia include preterm gestation, low birth weight, small and large for gestational age, and infants of diabetic mothers. Glucose monitoring is initiated soon after birth in these at-risk infants. The use of 40% oral glucose gel has been reported to be an effective, non-invasive treatment for transient neonatal hypoglycemia in late preterm and term infants within the first 48 hours of life and has been shown to prevent admission to the Neonatal Intensive Care Unit (NICU) and separation of mother and baby.

Methods: This is a retrospective (2017-2019) cohort study of infants admitted to the MBU at risk for hypoglycemia and enrolled in the hypoglycemia protocol at LAC+USC Medical Center. Oral glucose gel dose was administered to infants with hypoglycemia defined as blood glucose level below 45 mg/dL. Oral glucose gel dose was based on birth weight. Demographics and outcomes were collected from the electronic medical record, paper records and the Neonatal Information System newborn database.

Results: There were 410 infants included in this study, 186/410 (45%) of these patients developed hypoglycemia managed in the MBU while 35/410 (8.5%) developed hypoglycemia requiring NICU admission. Neonatal demographics was not different between groups however hypoglycemic infants requiring NICU admission had a higher rate of exposure to maternal preeclampsia and use of antenatal steroids, longer normalization of blood glucose levels and longest hospital stay. Rates of exclusive breastfeeding was highest in infants with normoglycemia. (Table)

Conclusion: Our preliminary data showed that exposure to maternal preeclampsia and antenatal steroids were risk factors associated with NICU admission. Despite no differences in gestational age or birth weight, these infants had longer time to normalize glucose and longer length of stay. Frequent breastfeeding should be encouraged in infants at risk for hypoglycemia. Collection of data is ongoing to verify these results in a larger sample size.