Lakhloufi, L. (2020) WELKE GEBOORTEGEWICHTSGRENS VOOR SCREENING OP NEONATALE HYPOGLYCEMIE BIJ DYSMATUREN MOET WORDEN GEHANTEERD? thesis, Medicine.
Full text available on request.Abstract
Background: Neonatal hypoglyceamia (NH) is a frequent problem, with potential neurological damage. Small for gestational age (SGA) is one of the predisposing factors for NH, however existing protocols use different definitions of birth weight as cut-off value for screening for NH. Aim: To determine whether the absolute cut-off value in birthweight of 2500 gram compared to the relative cut-off p10 is safe for indication of screening of NH. Methods: study including all newborns born in Isala Zwolle between 1 January 2015 until 1 April 2019 that were screened for NH. Hypoglycemia is defined as glucose concentrations of <2,6 mmol/L and <2,0 mmol/L. A clinically relevant hypoglycemia was defined as the administration of intravenous glucose. Results: Of 656 newborns with birthweight <p10, hypoglycemia <2.6mmol/L was found in 42,7% (<2500gram 52,2% vs 38,4% ³2500gram, risk reduction 13,8% [95%-confidence interval(CI)- 5,620; 21,980]), <2,0mmol/l in 16,8% (<2500gram 24,9% vs 13,1% ³2500gram, risk reduction 11,8% [95%-CI- 5,111; 18,489]) and 3,0% received intravenous glucose (<2500gram 4,9% vs 2,2% ³2500gram, risk reduction 2,7% [95%-CI- 0,550; 5,950]). Using a cut-off value of 2500 gram would have missed clinically relevant hypoglycemia defined as intravenous glucose administration in 10 (1,5%) of 656 newborns with birthweight ³2500 gram and <p10. On the contrary, 441 (67,2%) newborns would have been spared a minimum of 3 blood withdrawals. Conclusion: When the cut-off value of 2500 gram is used for the screening of NH instead of p10, blood drawings will be spared in 2/3 of SGA newborns at the expense of 1,5% in whom a potentially, clinically relevant hypoglycemia is undertreated. Therefore, we recommend changing the cut-off value in birthweight to 2800 gram for screening for NH.
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | dr. Bekhof, J. |
| Faculty: | Medical Sciences |
| Date Deposited: | 16 Apr 2024 11:26 |
| Last Modified: | 16 Apr 2024 11:26 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/3740 |
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