Objectives

To determine the proportion of well-appearing newborns screened for hypoglycemia, yield of specific screening criteria, and impact of screening on breastfeeding.

Study design

The retrospective study of well-appearing at-risk infants born ≥36 weeks’ gestation with blood glucose (BG) measurements obtained ≤72 h of age.

Results

Of 10,533 eligible well newborns, 48.7% were screened for hypoglycemia. Among tested infants, BG < 50 mg/dL occurred in 43% and 4.6% required intensive care for hypoglycemia. BG < 50 mg/dL was associated with lower rates of exclusive breastfeeding (22% vs 65%, p < 0.001). Infants screened due to late-preterm birth were most frequently identified as hypoglycemic. The fewest abnormal values occurred among appropriate weight, late-term infants of nondiabetic mothers.

Conclusion

Hypoglycemia risk criteria result in screening a large proportion of otherwise well newborns and negatively impact rates of exclusive breastfeeding. The risks and benefits of hypoglycemia screening recommendations should be urgently addressed.

中文翻译：

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新生儿低血糖筛查在婴儿护理中的临床影响。

目标

确定接受低血糖筛查的健康新生儿的比例、特定筛查标准的产生率以及筛查对母乳喂养的影响。

学习规划

对出生 ≥ 36 周、血糖 (BG) 测量结果良好的高危婴儿进行回顾性研究，其血糖 (BG) 测量值在 72 小时以内获得。

结果

在 10,533 名符合条件的新生儿中，48.7% 接受了低血糖筛查。在接受测试的婴儿中，BG < 50 mg/dL 发生在 43% 和 4.6% 的婴儿因低血糖而需要重症监护。BG < 50 mg/dL 与较低的纯母乳喂养率相关（22% 对 65%，p  < 0.001）。由于晚期早产而筛查的婴儿最常被确定为低血糖症。正常体重、非糖尿病母亲的晚期婴儿中发生的异常值最少。

结论

低血糖风险标准导致筛查大部分其他情况良好的新生儿并对纯母乳喂养率产生负面影响。应紧急解决低血糖筛查建议的风险和益处。