COMPARISON OF BLOOD GLUCOSE LEVEL IN PRETERM AND FULL-TERM BABIES IN 1ST 48 HOURS OF LIFE IN A TERTIARY CARE HOSPITAL

Abstract

Background: Neonatal glucose regulation is crucial for early metabolic adaptation, particularly in the first 48 hours of life when the transition from intrauterine to extrauterine environments occurs. Preterm neonates, due to their underdeveloped metabolic pathways, limited glycogen reserves, and increased energy demands, are at a higher risk of hypoglycemia, which can lead to severe neurological complications if untreated. Understanding the differences in blood glucose levels between preterm and full-term neonates is essential for optimizing clinical management and improving neonatal outcomes in tertiary care settings.

Objective: To compare blood glucose levels in preterm and full-term neonates during the first 48 hours of life in a tertiary care hospital.

Methods: This randomized controlled trial was conducted at the Department of Pediatrics, Sughra Shafi Medical Complex, Narowal, from February 20, 2023, to August 20, 2023. A total of 120 neonates were included, with an equal distribution of 60 preterm and 60 full-term newborns. Inclusion criteria consisted of neonates admitted to the NICU during the study period, classified as preterm (<37 weeks of gestation) or full-term (≥37 weeks). Exclusion criteria included major congenital anomalies and metabolic disorders. Blood glucose levels were measured using validated point-of-care glucose monitoring devices at predefined intervals over 48 hours. Statistical analysis was performed using IBM SPSS version 27.0, with a significance level set at p<0.05.

Results: Preterm neonates exhibited significantly lower blood glucose levels than full-term neonates across all time points (p<0.05). Mean glucose levels at birth were 49.4 ± 17.7 mg/dL in full-term neonates and 43.1 ± 15.1 mg/dL in preterm neonates (p=0.038). Hypoglycemia (<35 mg/dL) was significantly more prevalent in preterm neonates (43.3%) than in full-term neonates (18.3%) (p=0.003). Low birth weight (LBW <2.5 kg) was observed in 36.4% of hypoglycemic full-term neonates and 57.7% of hypoglycemic preterm neonates (p=0.007). Blood glucose levels were significantly lower in LBW neonates (65.3 ± 13.1 mg/dL) than in normal birth weight neonates (72.6 ± 14.8 mg/dL) (p=0.005).

Conclusion: This study highlights significant differences in blood glucose regulation between preterm and full-term neonates, emphasizing the heightened risk of hypoglycemia in preterm and LBW newborns. These findings underscore the importance of close glucose monitoring and timely interventions to optimize neonatal metabolic outcomes.