Araştırma Makalesi
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The frequency of hypoglycemia in newborn babies and the importance of breast milk in preventing hypoglycemia

Yıl 2022, , 76 - 82, 31.03.2022
https://doi.org/10.34087/cbusbed.986335

Öz

Objective: Hypoglycemia is the most common metabolic problem of the newborn and may cause cerebral injury if it persists for a long time or if it recurs frequently. The aim of this study is to determine the frequency of hypoglycemia in newborn babies with risk factors and to emphasize the importance of screening for hypoglycemia and the importance of breast milk in the prevention of hypoglycemia.
Materials and Methods: Newborn babies with risk factors born in our hospital between May 2020 and May 2021 and followed up with their mothers were included in the study. The first blood glucose in infants was measured 30 minutes after feeding. If normoglycemic values were obtained with feeding, the measurement was repeated at 2-3 hour intervals and before feeding, and scanning was terminated at the 48th hour of life. Babies who developed hypoglycemia and babies who did not develop were compared in terms of demographic characteristics, feeding patterns and blood glucose values.
Results: 260 infants with risk factors and screening for hypoglycemia were included in the study. Of these infants, 109 (41.9%) were preterm infants, 62 (23.8%) were infants of diabetic mothers (DAB), 32 (12.3%) were large for gestational age (LGA), 10' u (3.8%) were small for gestational age (SGA) and 47 (18.1%) were infants withintrauterine growth restriction (IUGR). In the scan, hypoglycemia was found in 24 (9.2%) of 260 babies. While the first feeding was breast milk in 78.5% of the infants, it was observed that the rate of infants fed only with breast milk decreased to 50.8% in subsequent feedings. During the follow-up period, it was observed that hypoglycemia was significantly less in babies who received only breast milk (p=0.003).
Conclusion: It is important to screen for postnatal hypoglycemia in babies with risk factors, especially babies of diabetic mothers. These babies, who are at risk of hypoglycemia, should be fed only with breast milk both in the early and late periods in order to protect them from hypoglycemia.

Kaynakça

  • Rozance, P.J, Hay, W.W, Jr, Describing hypoglycemia-definition or operational threshold? Early Human Development, 2010, 86(5), 275-80.
  • Stanley, C.A, Rozance, P.J, Thornto, P.S, De Leon, D.D, Harris, D, Haymond, M.W, et al., Re-evaluating “transitional neonatal hypoglycemia”: mechanism and implications for management, Journal of Pediatrics, 2015, 166, 1520-5.
  • Thornton, P.S, Stanley, C.A, DeLeon, D.D, Harris, D, Haymond, M.W, Hussain,, K, et al. Recommendations from the Pediatric Endocrine Society for Evaluation and Management of Persistent Hypoglycemia in neonates, infants, and children, Journal of Pediatrics, 2015, 167, 238e45.
  • Adamkin, D.H, Postnatal glucose homeostasis in late-preterm and term infants, Pediatrics, 2011, 127, 575-9.
  • Aliefendioğlu, D, Çoban, A, Hatipoğlu, N, Ecevit, A, Arısoy, A.E, Yeşiltepe, G, et al., Yenidoğanda hipoglisemiye yaklaşım: Türk Neonatoloji ve Çocuk Endokrinoloji ve Diyabet Dernekleri uzlaşı raporu, Türk Pediatri Arşivi, 2018, 53(Suppl 1), 224-233.
  • Brand, P.L.P, Molenaar, N.L.D, Kaaijk, C, Wierenga, W.S, Neurodevelopmental outcome of hypoglycaemia in healthy, large for gestational age, term newborns, Archives of Disease in Childhood, 2005, 90: 78-81.
  • Harris, D.L, Weston, P.J, Harding, J.E, Incidence of neonatal hypoglycemia in babies identified as at risk, Journal of Pediatrics, 2012, 161(5), 787-91.
  • Cornblath,, M, Hawdon J.M, Williams, A.F, Aynsley-Green, A, Ward-Plat,t MP, Schwartz, R, et al. Controversies regarding definition of neonatal hypoglycemia: Suggested operational thresholds, Pediatrics, 2000, 105(5), 1141–5.
  • Deshpande, S, Platt, M.W, The investigation and management of neonatal hypoglycaemia. Seminars in Fetal and Neonatal Medicine, 2005, 10(4), 351-61.
  • Williams, A.F, Neonatal hypoglycaemia: clinical and legal aspects, Seminars in Fetal and Neonatal Medicine, 2005, 10(4), 363-8.
  • Canadian Pediatric Society, Screening guidelines for newborns at risk for low blood glucose, Paediatrics & Child Health, 2004, 9(10), 723- 40.
  • Lucas, A, Morley, R, Cole, T.J, Adverse neurodevelopmental outcome of moderate neonatal hypoglycemia, British Medical Journal, 1988, 297(6659): 1304-8.
  • Hawdon, J.M, Neonatal Hypoglycemia: Are Evidence-based Clinical Guidelines Achievable? NeoReviews, 2014, 15(3, e91-8.
  • Devaskar, S.U, Garg, M, Disorders of carbohydrate metabolism in the neonate, Fanaroff and Martin’s Neonatal-Perinatal Medicine: Diseases of the fetus and infant, Martin, J.R, Fanaroff, A.A, Walsh, M.C, (eds). 10th ed. Philadelphia: Elsevier Saunders, 2015, p1437.
  • Holtrop, P.C, The frequency of hypoglycemia in full-term large and small for gestational age newborns, American Journal of Perinatology, 1993, 10(2), 150-4.
  • Michael, R, Narvey, Seth, D, Marks, The screening and management of newborns at risk for low blood glucose, Paediatrics & Child Health, 2019, 24(8), 536-544.
  • Croke, J, Sullivan, M, Ryan-Drover A, Randell, E, Andrews, W, Aziz, K. Two hour blood glucose levels in at-risk babies: An audit of Canadian guidelines, Paediatrics & Child Health, 2009, 14, 238-44.
  • Hawdon, J.M, Ward Platt, M.P, Aynsley-Green, A, Patterns of metabolic adaptation in term and preterm infants in the first postnatal week, Archives of Disease in Childhood, 1992, 67, 357-65.
  • Mukhopadhyay, S, Wade, K.C, Dhudasia, M.B, Skerritt, L, Chou , J.H, Dukhovny, D, et al,. Clinical Impact of Neonatal Hypoglycemia Screening in the Well-Baby Care, Journal of Perinatology, 2020, 40(9), 1331-1338.

Yenidoğan bebeklerde hipoglisemi sıklığı ve hipoglisemiden korunmada anne sütünün önemi

Yıl 2022, , 76 - 82, 31.03.2022
https://doi.org/10.34087/cbusbed.986335

Öz

Giriş ve Amaç: Hipoglisemi, yenidoğanın en sık metabolik sorunudur ve uzun sürmesi ya da sık tekrarlaması durumunda serebral zedelenmeye neden olabilir. Bu çalışmanın amacı doğum sonrası anne yanında izlenen ve risk faktörü olan yenidoğan bebeklerde hipoglisemi sıklığını belirlemek, hipoglisemi taramasının önemini ve hipoglisemiden korunmada da anne sütünün önemini vurgulamaktır.
Gereç ve Yöntemler: Çalışmaya Mayıs 2020 ile Mayıs 2021 tarihleri arasında hastanemizde doğan ve anne yanında izlenen, risk faktörü olan yenidoğan bebekler alındı. Bebeklerde ilk kan glukozu, beslendikten 30 dakika sonra ölçüldü. Beslenme ile normoglisemik değerler elde edilmesi durumunda, ölçüm 2-3 saat aralıklarla ve beslenme öncesi olacak şekilde tekrarlandı, yaşamın 48. saatinde tarama sonlandırıldı. Hipoglisemi gelişen bebeklerle gelişmeyen bebekler demografik özellikleri, beslenme şekilleri ve kan glukoz değerleri açısındn karşılaştırıldılar.
Bulgular: Çalışmaya risk faktörü olan ve hipoglisemi taraması yapılan 260 bebek alındı. Bu bebeklerin 109’u (%41,9) preterm bebek, 62’si (%23,8) diabetik anne bebeği (DAB), 32’si (%12,3) gebelik haftasına göre büyük bebek (LGA), 10’u (%3,8) gebelik haftasına göre küçük bebek (SGA) ve 47’si (%18,1) intrauterin büyüme kısıtlılığı (İUBK) olan bebeklerdi. Yapılan taramada 260 bebeğin 24’ünde (%9,2) hipoglisemi saptandı. Bebeklerin %78,5’inde ilk beslenme anne sütüyken, sonraki beslenmelerde sadece anne sütü ile beslenen bebeklerin oranının %50,8’e düştüğü görüldü. İzlem boyunca sadece anne sütü alan bebeklerde anlamlı olarak hipogliseminin daha az olduğu görüldü (p=0,003).
Sonuç: Risk faktörü olan bebeklerin, özellikle de diabetik anne bebeklerinin doğum sonrası hipoglisemi taramalarının yapılması önemlidir. Hipoglisemi riski taşıyan bu bebeklerin, hipoglisemiden korumak için hem erken hem de geç dönemde sadece anne sütü ile beslenmeleri sağlanmalıdır.

Kaynakça

  • Rozance, P.J, Hay, W.W, Jr, Describing hypoglycemia-definition or operational threshold? Early Human Development, 2010, 86(5), 275-80.
  • Stanley, C.A, Rozance, P.J, Thornto, P.S, De Leon, D.D, Harris, D, Haymond, M.W, et al., Re-evaluating “transitional neonatal hypoglycemia”: mechanism and implications for management, Journal of Pediatrics, 2015, 166, 1520-5.
  • Thornton, P.S, Stanley, C.A, DeLeon, D.D, Harris, D, Haymond, M.W, Hussain,, K, et al. Recommendations from the Pediatric Endocrine Society for Evaluation and Management of Persistent Hypoglycemia in neonates, infants, and children, Journal of Pediatrics, 2015, 167, 238e45.
  • Adamkin, D.H, Postnatal glucose homeostasis in late-preterm and term infants, Pediatrics, 2011, 127, 575-9.
  • Aliefendioğlu, D, Çoban, A, Hatipoğlu, N, Ecevit, A, Arısoy, A.E, Yeşiltepe, G, et al., Yenidoğanda hipoglisemiye yaklaşım: Türk Neonatoloji ve Çocuk Endokrinoloji ve Diyabet Dernekleri uzlaşı raporu, Türk Pediatri Arşivi, 2018, 53(Suppl 1), 224-233.
  • Brand, P.L.P, Molenaar, N.L.D, Kaaijk, C, Wierenga, W.S, Neurodevelopmental outcome of hypoglycaemia in healthy, large for gestational age, term newborns, Archives of Disease in Childhood, 2005, 90: 78-81.
  • Harris, D.L, Weston, P.J, Harding, J.E, Incidence of neonatal hypoglycemia in babies identified as at risk, Journal of Pediatrics, 2012, 161(5), 787-91.
  • Cornblath,, M, Hawdon J.M, Williams, A.F, Aynsley-Green, A, Ward-Plat,t MP, Schwartz, R, et al. Controversies regarding definition of neonatal hypoglycemia: Suggested operational thresholds, Pediatrics, 2000, 105(5), 1141–5.
  • Deshpande, S, Platt, M.W, The investigation and management of neonatal hypoglycaemia. Seminars in Fetal and Neonatal Medicine, 2005, 10(4), 351-61.
  • Williams, A.F, Neonatal hypoglycaemia: clinical and legal aspects, Seminars in Fetal and Neonatal Medicine, 2005, 10(4), 363-8.
  • Canadian Pediatric Society, Screening guidelines for newborns at risk for low blood glucose, Paediatrics & Child Health, 2004, 9(10), 723- 40.
  • Lucas, A, Morley, R, Cole, T.J, Adverse neurodevelopmental outcome of moderate neonatal hypoglycemia, British Medical Journal, 1988, 297(6659): 1304-8.
  • Hawdon, J.M, Neonatal Hypoglycemia: Are Evidence-based Clinical Guidelines Achievable? NeoReviews, 2014, 15(3, e91-8.
  • Devaskar, S.U, Garg, M, Disorders of carbohydrate metabolism in the neonate, Fanaroff and Martin’s Neonatal-Perinatal Medicine: Diseases of the fetus and infant, Martin, J.R, Fanaroff, A.A, Walsh, M.C, (eds). 10th ed. Philadelphia: Elsevier Saunders, 2015, p1437.
  • Holtrop, P.C, The frequency of hypoglycemia in full-term large and small for gestational age newborns, American Journal of Perinatology, 1993, 10(2), 150-4.
  • Michael, R, Narvey, Seth, D, Marks, The screening and management of newborns at risk for low blood glucose, Paediatrics & Child Health, 2019, 24(8), 536-544.
  • Croke, J, Sullivan, M, Ryan-Drover A, Randell, E, Andrews, W, Aziz, K. Two hour blood glucose levels in at-risk babies: An audit of Canadian guidelines, Paediatrics & Child Health, 2009, 14, 238-44.
  • Hawdon, J.M, Ward Platt, M.P, Aynsley-Green, A, Patterns of metabolic adaptation in term and preterm infants in the first postnatal week, Archives of Disease in Childhood, 1992, 67, 357-65.
  • Mukhopadhyay, S, Wade, K.C, Dhudasia, M.B, Skerritt, L, Chou , J.H, Dukhovny, D, et al,. Clinical Impact of Neonatal Hypoglycemia Screening in the Well-Baby Care, Journal of Perinatology, 2020, 40(9), 1331-1338.
Toplam 19 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Çocuk Sağlığı ve Hastalıkları
Bölüm Araştırma Makalesi
Yazarlar

Sema Tanrıverdi 0000-0002-5681-3647

Yayımlanma Tarihi 31 Mart 2022
Yayımlandığı Sayı Yıl 2022

Kaynak Göster

APA Tanrıverdi, S. (2022). Yenidoğan bebeklerde hipoglisemi sıklığı ve hipoglisemiden korunmada anne sütünün önemi. Celal Bayar Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi, 9(1), 76-82. https://doi.org/10.34087/cbusbed.986335
AMA Tanrıverdi S. Yenidoğan bebeklerde hipoglisemi sıklığı ve hipoglisemiden korunmada anne sütünün önemi. CBU-SBED. Mart 2022;9(1):76-82. doi:10.34087/cbusbed.986335
Chicago Tanrıverdi, Sema. “Yenidoğan Bebeklerde Hipoglisemi sıklığı Ve Hipoglisemiden Korunmada Anne sütünün önemi”. Celal Bayar Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi 9, sy. 1 (Mart 2022): 76-82. https://doi.org/10.34087/cbusbed.986335.
EndNote Tanrıverdi S (01 Mart 2022) Yenidoğan bebeklerde hipoglisemi sıklığı ve hipoglisemiden korunmada anne sütünün önemi. Celal Bayar Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi 9 1 76–82.
IEEE S. Tanrıverdi, “Yenidoğan bebeklerde hipoglisemi sıklığı ve hipoglisemiden korunmada anne sütünün önemi”, CBU-SBED, c. 9, sy. 1, ss. 76–82, 2022, doi: 10.34087/cbusbed.986335.
ISNAD Tanrıverdi, Sema. “Yenidoğan Bebeklerde Hipoglisemi sıklığı Ve Hipoglisemiden Korunmada Anne sütünün önemi”. Celal Bayar Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi 9/1 (Mart 2022), 76-82. https://doi.org/10.34087/cbusbed.986335.
JAMA Tanrıverdi S. Yenidoğan bebeklerde hipoglisemi sıklığı ve hipoglisemiden korunmada anne sütünün önemi. CBU-SBED. 2022;9:76–82.
MLA Tanrıverdi, Sema. “Yenidoğan Bebeklerde Hipoglisemi sıklığı Ve Hipoglisemiden Korunmada Anne sütünün önemi”. Celal Bayar Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi, c. 9, sy. 1, 2022, ss. 76-82, doi:10.34087/cbusbed.986335.
Vancouver Tanrıverdi S. Yenidoğan bebeklerde hipoglisemi sıklığı ve hipoglisemiden korunmada anne sütünün önemi. CBU-SBED. 2022;9(1):76-82.