Predictive Factors of Hypoglycaemia in Neonates Delivered by means of Caesarean Sections
Keywords:hypoglycaemia, neonates, caesarean sections
Objective: To investigate factors that could predict occurrences of hypoglycaemia in neonates delivered
by means of caesarean sections.
Design: Retrospective case-control study.
Methodology: The study sample, obtained through simple random sampling, consisted of 260 neonates who were delivered by means of caesarean sections and admitted to the neonatal care units of Phra Chom Klao Hospital and Hua Hin Hospital. Half of the neonates were classifed as a study group and half of them as a control group based on the criteria. Data were collected through a retrospection of medical records and a hypoglycaemia prediction form. Descriptive statistics and logistic regression analysis were used for data
Results: Body mass index (BMI), nothing-per-oral (NPO) duration, types of intravenous ﬂuid
(IVF) for the mothers, and disproportionate birth weight for gestational age could jointly predict 74.3% of hypoglycaemia in neonates delivered by means of caesarean section (p < .01). First, neonates whose mothers had BMI ≥ 25 kg/m2 were 7.88 times more likely to develop hypoglycaemia than those whose mothers had BMI < 25 kg/m2 (95% CI: 3.23-19.18). Second, neonates whose mothers received NPO for ≥ 6 hours were 26.41 times more likely to develop hypoglycaemia than those whose mothers received NPO for < 6 hours (95% CI: 8.32-83.77). Next, neonates whose mothers were given glucose-free intravenous ﬂuid displayed a 5.03-time greater likelihood to develop hypoglycaemia than those whose mothers received glucose-containing intravenous ﬂuid (95% CI: 2.19-12.02). Finally, neonates who were too small and too large for gestational age (SGA and LGA) were respectively 12.97 and 64.06 times more likely to develop hypoglycaemia than those with appropriate weight for gestational age (95% CI: 1.20-139.55; 95% CI: 14.42-284.43).
Recommendations: Throughout pregnancy, pregnant women should be monitored to avoid becoming
overweight and prevent their newborns from having disproportionate birth weight for gestational age. During the prepartum period, the mothers should undergo an NPO period of less than 6 hours and should receive intravenous ﬂuid with suffcient glucose content, to prevent their caesarean-delivered neonates from developing hypoglycaemia. Additionally, a screening process is highly recommended for all caesarean-delivered neonates with any of the above-stated risk factors.
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