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Review
. 2020 Jan;109(1):31-44.
doi: 10.1111/apa.14955. Epub 2019 Aug 27.

Swedish national guideline for prevention and treatment of neonatal hypoglycaemia in newborn infants with gestational age ≥35 weeks

Dirk Wackernagel  1 , Anna Gustafsson  1 , Anna-Karin Edstedt Bonamy  2 , Annika Reims  3 , Fredrik Ahlsson  4 , Maria Elfving  5 , Magnus Domellöf  6 , Ingrid Hansen Pupp  7
Affiliations
Review

Swedish national guideline for prevention and treatment of neonatal hypoglycaemia in newborn infants with gestational age ≥35 weeks

Dirk Wackernagel et al. Acta Paediatr. 2020 Jan.

Abstract

Aim: Postnatal hypoglycaemia in newborn infants remains an important clinical problem where prolonged periods of hypoglycaemia are associated with poor neurodevelopmental outcome. The aim was to develop an evidence-based national guideline with the purpose to optimise prevention, diagnosis and treatment of hypoglycaemia in newborn infants with a gestational age ≥35 + 0 weeks.

Methods: A PubMed search-based literature review was used to find actual and applicable evidence for all incorporated recommendations. The GRADE (Grading of Recommendations, Assessment, Development and Evaluation) approach was used for grading the evidence of the recommendations.

Results: Recommendations for the prevention of neonatal hypoglycaemia were extended and updated, focusing on promotion of breastfeeding as one prevention strategy. Oral dextrose gel as a novel supplemental therapy was incorporated in the treatment protocol. A new threshold-based screening and treatment protocol presented as a flow chart was developed.

Conclusion: An updated and evidence-based national guideline for screening and treatment of neonatal hypoglycaemia will support standardised regimes, which may prevent hypoglycaemia and the risk for hypoglycaemia-related long-term sequelae.

Keywords: breastfeeding; dextrose gel; guideline; hypoglycaemia; newborn infant.

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References

REFERENCES

    1. Harris DL, Weston PJ, Harding JE. Incidence of neonatal hypoglycemia in babies identified as at risk. J Pediatr 2012; 161: 787-791.
    1. Kaiser JR, Bai S, Gibson N, et al. Association between transient newborn hypoglycemia and fourth-grade achievement test proficiency: a population-based study. JAMA Pediatr 2015.
    1. Harris DL, Weston PJ, Signal M, Chase JG, Harding JE. Dextrose gel for neonatal hypoglycaemia (the Sugar Babies Study): a randomised, double-blind, placebo-controlled trial. Lancet 2013.
    1. Weston PJ, Harris DL, Battin M, Brown J, Hegarty JE, Harding JE. Oral dextrose gel for the treatment of hypoglycaemia in newborn infants. Cochrane Database Syst Rev 2016; (5): CD011027.
    1. Troughton K, Corrigan N, Tait R. Hypostop gel in the treatment of neonatal hypoglycaemia: a randomised controlled trial. Arch Dis Child 2000; 82: A29-A32.

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