79: Hypoglycemia in Full-Term Newborns with No Pre-Identified Risk Factors
Notice bibliographique
Résumé
Monitoring protocols are used for early detection of hypoglycemia in at-risk term newborns such as infants of diabetic mothers, those with growth restriction or macrosomia and infants with acute neonatal illness. Universal glucose monitoring is not recommended since benign transient hypoglycemia occurs in up to 14% of healthy term newborns. Clinically significant hypoglycemia is felt to be uncommon in newborns with no known risk factors. However, unmonitored newborns who do become hypoglycemic often have a delay in diagnosis and treatment as onset of symptoms may be the indication to measure blood glucose. To determine the prevalence of significant hypoglycemia amongst full term newborns with no pre-identified risk factors in a regional centre. We reviewed the charts of newborns born at 37 to 42 weeks, birthweight 2500 g to 3999 g with documented hypoglycemia at a regional centre over a three year period. We focussed on those with a glucose level of <2.0 mmol/L and requiring IV dextrose. Infants of mothers with gestational and pre-gestational diabetes were excluded as were infants with birth depression, transient respiratory distress and those with acute illness. From a population of 6272 term newborns we identified eight hypoglycemic infants who met the criteria. Four of the newborns were less than the10th centile for weight and one baby had Down Syndrome. Of the remaining three hypoglycemic infants the first presented at 26 h of life with jitteriness. Blood glucose was 1.3 mmmol/L. Hypoglycemia resolved three days later. Polycythemia was noted. Mother was obese and hypertensive. The second case presented with jitteriness at 60 h of life with blood glucose 1.5 mmol/L. Hypoglycemia resolved a day later. No diagnosis was made. Mother was obese. The third case presented at 13 h with jitteriness and blood glucose 0.3 mml/L. He subsequently had three seizures. Hypoglycemia resolved six days later. The diagnosis was transient hyperinsulinism. Mother was hypertensive. Use of <10th centile weight parameter, as recommended by the CPS, is superior to an arbitrary weight cut-off in identifying growth-restricted term newborns who may be at risk of hypoglycemia. A small number of normal birth weight newborns fall outside current monitoring recommendations yet have clinically significant hypoglycemia. Many of these infants do not have a chronic underlying metabolic or endocrine disorder. We recently launched a Canadian Pediatric Survellance Program project to determine incidence of hypoglycemia in term newborns without pre-identified risk factors, to document presentation and early morbidity and to obtain clues about unrecognized or underappreciated risk factors.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».