Predictive Factors of Asymptomatic Hypoglycemia in Late Preterm Infants: A Retrospective Case-control Study

Abstract

Asymptomatic hypoglycemia is a common but often overlooked issue in late preterm infants, which can lead to negative neurodevelopmental outcomes. Identifying predictive factors is essential for early detection and intervention. However, published evidence regarding asymptomatic hypoglycemia among late preterm infants in Thailand remains limited. This retrospective case-control study encompassed 586 late preterm infants (293 cases and 293 controls) born and admitted to a university hospital in Bangkok between January 2017 and December 2022. Data were extracted from electronic medical records. The instruments employed included Infant and Maternal Record Forms. Data analysis was conducted using descriptive statistics and multiple logistic regression.

The study revealed that 53.9% of infants with asymptomatic hypoglycemia were female, with an average gestational age of 35.4 ± 0.75 weeks. The mean point-of-care glucose testing one hour post-birth was 34.8 ± 5.09 mg/dL. Significant predictive factors for asymptomatic hypoglycemia in infants were identified, including being small for gestational age, large for gestational age, and experiencing prolonged fasting before delivery for more than six hours. Collectively, these three factors accounted for only 10.4% of the risk of asymptomatic hypoglycemia in late preterm infants. Therefore, further studies should include other factors such as maternal medications, infant feeding practices, and metabolic disorders. Based on these findings, nurses must remain vigilant for the development of asymptomatic hypoglycemia in these infants to prevent severe complications or long-term effects on infant brain development and health. Furthermore, maternal education should also emphasize responsive feeding practices and recognition of warning signs of neonatal hypoglycemia in high-risk infants.