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Definition and adverse consequences of neonatal hypoglycemia during perioperative period

2021.09.19 / Sunday
Definition and adverse consequences of neonatal hypoglycemia during perioperative period




Is it possible for a newborn to have hypoglycemia?

The answer is, it is possible.


Definition of neonatal hypoglycemia


The current mainstream opinion defines hypoglycemia as:

Regardless of gestational age and age, whole blood glucose <2.2mmol/L (40mg/dl) was used as the standard for neonatal hypoglycemia, and <2.6mmol/L (47mg/dl) was used as the standard for neonatal hypoglycemia intervention.

Some scholars have also proposed that healthy newborns with a birth weight of more than 2,000 g are non-inferior to the

intervention of blood glucose 2.0mmol/L (36mg/dl) compared with the blood glucose 2.6mmol/L intervention.


In 2015, the Pediatric Endocrinology Society (PES) pointed out that the blood sugar level of high-risk children with hypoglycemia should be maintained at 2.8mmol/L (50mg/dl) within 48 hours after birth.


Adverse consequences of neonatal hypoglycemia


Severe and persistent hypoglycemia can cause neonatal seizures and brain damage. Hypoglycemia activates N-methyl-D-aspartate (NMDA) receptors, leading to the production of oxygen free radicals, inducing cell apoptosis, and then leading to Cerebral blood flow changes, ketone body lactic acid hyperplasia, and central nervous system damage.


Compared with severe and single episodes of hypoglycemia, less severe but repeated episodes of hypoglycemia may have more serious long-term negative effects.

A study showed that infants with recurrent hypoglycemia during the neonatal period had lower developmental scores at 3.5 and 5 years of age compared with infants with single and severe hypoglycemia episodes;

Research has pointed out that even short-term, mild to moderate asymptomatic hypoglycemia may permanently lead to abnormal brain development and impair subsequent learning ability.