Blood Glucose Level and Risk Factor Affecting Glucose Homeostasis in Premature Newborns: A Retrospective Study

Abstract

Introduction: Neonatal blood glucose levels are affected by pregnancy outcomes. Preterm infants are more prone to hypo- and hyperglycaemia compared to full-term newborns. Understanding glucose fluctuation in these infants is important for improving early diagnostic accuracy and neonatal survival rate. Aim: To explore the glucose levels and risk factors affecting glucose homeostasis among premature neonates. Materials and Methods: A retrospective study was conducted from January 1 to March 31, 2017, at the Maternity Teaching Hospital affiliated with Hawler Medical University in Erbil city, Iraq. A total of 212 preterm newborns treated in the Neonatal Intensive Care Unit (NICU) were included. Information concerning premature neonates (glucose status, birth weight, and health status) of 24-hour-old newborns and maternal data (ages and gestation) were collected. Statistical analysis was conducted using Statistical Package for the Social Sciences (SPSS) software; methods used are descriptive statistics and inferential tests. Results: Mean maternal age was 26.7±6.9 years and 113 (53.3%) of women were in young age (20-29 years). A total of 179 (84.4%) of the neonates had normal random blood glucose levels. Highest percentage of maternal 139 (65.6%) were in the group of 33 to 36 weeks of Gestational Age (GA). More than half 135 of premature newborns (63.7%), were in Low Birth Weight (LBW) group. Negative significant correlation found between random blood glucose with GA (unstandardised coefficient β= -1.3; 95% CI: -2.5 to -0.196) and with birth weight of newborns unstandardised coefficient β=-8.5; 95% CI: -14.3 to -2.7). Apgar moderate scores of 4-6 at five minutes increased with increase random blood glucose levels. While Apgar good 7-10 scores group at 10 minutes inversely associated with random blood glucose, (r=-0.196, p-value=0.021). Conclusion: Most neonates demonstrated normal blood glucose levels. However, lower GA and birth weight were associated with a higher level of glucose, likely due to physiological stress and metabolic immaturity. This may be reflected in Apgar scores, as these infants require more time to adapt to extrauterine life.