Very low birth weight preterm infants are at risk for hypoglycemia once on total enteral nutrition

摘要

Objective: To determine the occurrence of hypoglycemic episodes in very low birth weight preterm infants under total enteral nutrition and identify potential risk factors. Methods: In this single centre cohort study, we analyzed the patients' charts of preterm infants with a gestational age <32 weeks (n=98). Infants were analyzed in two groups (group 1: birth weight <1000g, n=54; group 2: birth weight 1000-1499g, n=44). A total of 3640 pre-feeding blood glucose measurements were screened. Risk factors for the development of hypoglycemia were identified by linear and multiple logistic regression analyses. Results: In group 1, 44% (24 of 54) of infants experienced at least one asymptomatic episode of blood glucose <45mg/dl (<2.5mmol/l) as compared with 23% (10 of 44) in group 2. Regression analysis identified low gestational age and high carbohydrate intake as potential risk factors for the development of hypoglycemia. Conclusions: Our results indicate that numerous preterm infants experience hypoglycemic episodes once on total enteral nutrition, especially those who are <1000g at birth and those with a higher carbohydrate intake. Further studies evaluating a possible impact of these common although asymptomatic episodes on later development could help to better define thresholds that should be considered as "hypoglycemia" in this population.