Abstract
Objective Hypoglycemia is a significant risk factor for perinatal brain injury and adverse
outcomes, particularly in infants requiring resuscitation following hypoxic ischemic
(HI) insult. We aimed to study blood glucose (BG) levels in physiologically stressed
infants in the presence or absence of epinephrine (Epi) administration at resuscitation
in the first 24 hours after birth.
Study Design A retrospective chart review of all infants with heart rate (HR) < 100/min at 1 minute
requiring positive pressure ventilation (PPV) at birth was performed. Infants were
classified into two groups as follows: (1) PPV group: infants' HR improved with PPV only at resuscitation, and Epi group: infants received Epi at resuscitation for persistent bradycardia. Serial measurements
of BG levels collected and glucose infusion rate (GIR) calculated at 24 hours.
Results By design, infants in the Epi group had lower cord pH and higher base deficit. BG
was significantly lower overtime in premature infants ≤32 weeks of gestation in the
Epi group. The BG was markedly higher in near-term and term infants in the Epi group
compared with the PPV group. Hypoglycemia was more common despite administration of
higher GIR in premature infants ≤32 weeks of gestation.
Conclusion In the presence of physiological stress, premature infants are more at risk for hypoglycemia
than term infants.
Keywords
hyperglycemia - epinephrine - asphyxia - resuscitation - hypoglycemia - newborns
