Screening of the neonatal glycemia and its pitfalls

Czech version

Authors: M. Wita ^1,2; J. Hálek ^1,2
Authors‘ workplace: Novorozenecké oddělení, FN Olomouc ¹; LF Univerzity Palackého, Olomouc ²
Published in: Čes-slov Neonat 2022; 28 (2): 90-95.
Category: Reviews

Overview

There is a natural drop in the level of plasma glucose in the first hours after birth. As a result of metabolic and hormonal adaptation, glycemic values normalize early in most newborns. However, the ability of this physiological adaptation may be impaired in risk groups of newborns. Knowledge of the connection between hypoglycemia in the neonatal period and a possible subsequent permanent neurological deficit has already been published in the past. Perhaps that is why blood glucose measurement is one of the most common laboratory tests performed in neonatal wards. However, there are no uniform recommendations for the screening and therapy of neonatal hypoglycemia worldwide. The interpretation of clinical studies, with regard to the value of glycemia and possible adverse neurological outcome, is very limited. This is primarily due to the great methodological variability of the clinical studies. National guidelines are thus rather created as consensus recommendations of experts. The review article provides basic knowledge regarding the adaptation of glucose metabolism after birth. There are the basic assumptions of screening for hypoglycemia, as well as a wide range of information and factors that can influence the effectiveness of screening and the interpretation relation between level of the glycemia, clinical condition of the baby and possible neurological consequences.

Keywords:

management – screening – hypoglycemia – newborn – adverse outcome

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