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. 2018 Mar;38(3):258-263.
doi: 10.1038/s41372-017-0003-9. Epub 2017 Dec 5.

Racial differences in neonatal hypoglycemia among very early preterm births

Tamarra James-Todd  1   2 , Melissa I March  3   4 , Jacqueline Seiglie  5 , Munish Gupta  6 , Florence M Brown  7 , Joseph A Majzoub  8
Affiliations

Racial differences in neonatal hypoglycemia among very early preterm births

Tamarra James-Todd et al. J Perinatol. 2018 Mar.

Abstract

Objective: To determine whether the prevalence of neonatal hypoglycemia differs by race/ethnicity.

Study design: A retrospective cohort study using prospectively collected data from 515 neonates born very preterm (<32 weeks) to normoglycemic women and admitted to the neonatal intensive care unit (NICU) at a major tertiary hospital in Boston, MA, between 2008 and 2012.

Results: A total of 61%, 12%, 7%, 7%, and 13% were White, Black, Hispanic, Asian, and Other, respectively. Among the 66% spontaneous preterm births, 63% of the black neonates experienced hypoglycemia (blood glucose level < 40 mg/dL), while only 22-30% of the other racial/ethnic neonates did so (Black vs. White RR 2.15; 95% CI: 1.54-3.00). After adjusting for maternal education, maternal age, multiple gestations, delivery type, gestational age, birth weight, and neonates' sex, this association remained significant (adjusted Black vs. White RR: 1.61, 95% CI: 1.13-2.29). An increased risk of infant hypoglycemia was not seen in infants of other racial/ethnic groups, nor in any racial/ethnic group with a medically indicated preterm birth.

Conclusions: Black neonates delivered for spontaneous (but not medical) indications at <32 weeks had a higher risk of hypoglycemia, which could provide critical information about mechanisms of preterm birth and adverse postnatal outcomes in this high-risk group.

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Conflict of interest statement

Disclosure: None of the authors declares any conflicts in relevant financial interests, activities, relationships, or affiliations. This study was supported by NIH K12HD051959 (TJT), NIH R01ES026166 (TJT), and NIH T32DK007699 (JM).

Figures

Figure 1
Figure 1
Derivation of spontaneous preterm birth study population
Figure 2
Figure 2
Percentage of neonates born spontaneously <32 weeks gestation with hypoglycemia by race/ethnicity. For each group, the number of hypoglycemic neonates divided by the total number of neonates (from Table 1) is shown within each bar. *P = 0.003, differences among racial/ethnic groups, by ANOVA.
Figure 3
Figure 3
Percentage of neonates born for medical indications <32 weeks gestation with hypoglycemia by race/ethnicity. For each group, the number of hypoglycemic neonates divided by the total number of neonates (from Table 1) is shown within each bar. *P = 0.99, differences among racial/ethnic groups, by ANOVA
See this image and copyright information in PMC

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