pediatrics
Neonatal Hypoglycemia
Introduction
Hypoglycemia is difficult to define in neonates but is generally considered a serum glucose concentration<40 mg/dL (<2.2 mmol/L) in symptomatic term neonates,<45 mg/dL (<2.5 mmol/L) in asymptomatic term neonates between 24 hours and 48 hours of life, or<30 mg/dL (<1.7 mmol/L) in preterm neonates in the first 48 hours. Risk factors include prematurity, being small for gestational age, maternal diabetes, and perinatal asphyxia. The most common causes are deficient glycogen stores, delayed feeding, and hyperinsulinemia. Signs include tachycardia, cyanosis, seizures, and apnea. Diagnosis is suspected empirically and is confirmed by glucose testing. Prognosis depends on the underlying condition. Treatment is enteral feeding or IVdextrose. (See also general discussion of Hypoglycemia .) 