Hyperglycemia in transported neonates: A tertiary care experience

Nihar Ranjan Mishra, S K Sahoo, S Panda

Abstract


Introduction: Hyperglycemia is common in low birth weight and sick neonates which affect them adversely due to hyperosmolarity. As these neonates need often referral to higher setup, maintenance of euglycemia during transport should be emphasized. Objective: To know the prevalence of hyperglycemia on admission among outborn neonates and analyze the association of different transport variables and other clinical parameters with it. Methods: An observational, analytical, and cross-sectional study was designed and conducted on outborn neonates, enrolled by simple consecutive sampling from November 2014 to October 2016. All data were analyzed using SPSS version 24 and Microsoft Excel version 16 software. Results: Out of 394 outborn neonates, 33.75% were hyperglycemic. 76.4% newborns were transported by ambulance, 94.9% were stabilized before referral, 61.2% had accompanying paramedics, 86.5% neonates given intravenous fluid (IVF) during transport, 61.4% transported by moderately equipped, and 38.6% by poorly equipped vehicle. Admission hyperglycemia was significantly associated with variables such as gestational age, birth asphyxia, type of transport vehicle, duration of transport, IVF during transport, hypoxic ischemic encephalopathy, and neonatal jaundice with p<0.05. Logistic regression model taking variable which shows a strong association, we can predict 70.3% time correctly the hyperglycemia on admission. Conclusion: Prevalence of hyperglycemia found to be quite common in referred neonates. Although there is quite improvement in neonatal transport due to the implementation of various government transport schemes for patients, specialized neonatal transport service with accompanied skill personnel and care during transport is a long way to go.


Keywords


Birth asphyxia, Gestational age, Hyperglycemia, Intravenous fluid, Neonatal transport, Outborn

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