Zanco Journal of Medical Sciences
Skip Navigation Links
Available Issues
Editorial Board
Information for Authors
Review Process
Links and Contacts
  Zanco J Med Sci:  Apr. 2018; 22 (1): 134-140

Prevalence and severity of hypoglycemia in a sample of neonates in Erbil city

Ahmed S. Rajab *, Dlair A.K. Chalabi **, Abbas A. Al-Rabaty **


* Department of Pediatric, Rapareen Teaching Hospital, Erbil, Iraq.

** Department of Pediatric, College of Medicine, Hawler Medical University, Erbil, Iraq.


Background and objective: Transient hypoglycemia may affect the newborn in the first hour of life and is the most prevalent metabolic disorder. The maternal-fetal diffusion that keeps the fetal glucose level nearly two thirds of the maternal glucose concentration. This study aimed to identify the prevalence of hypoglycemia and detect certain demographic and maternal factors that may be associated with and their relation to neonatal blood glucose level.

Methods: A prospective cross-sectional study was conducted in Erbil Maternity Teaching Hospital in Erbil city during a period of 4 months, from February 1st to May 31st, 2013. A total of 400 newborns from the neonatal care unit and the delivery and waiting rooms were included in the study. All of them were less than 3 hours of age and didn’t receive oral feeding.

Results: Among 400 neonates, 65 were hypoglycemic confirmed by serum sample with a prevalence of 16.25% during the first 3 hours. Most of the screened neonates were male (male: female ratio 1,45: 1). A highly significant association was found between neonatal hypoglycemia with preterm babies and hypoglycemic mother. Grand multiparity, low birth weight and head circumference also may predispose to hypoglycemia while mean length of affected babies was lower than the normoglycemic group. The severity of hypoglycemia was significantly associated with gestational age, birth weight and maternal serum glucose status.

Conclusion: Hypoglycemia is present in relatively high frequency among newly born babies and certain factors like prematurity, low birth weight and maternal hypoglycemia can predict its occurrence and its severity.

Keywords: Gestational age; Hypoglycemia; Maternal; Neonatal.



1. Kalhan S, Peter-Wohl S. Hypoglycemia: What is it for the neonate? Am J Perinatol 2000; 17:11-8.

2. Boluyt N, van Kempen A, Offringa M. Neurodevelopment after neonatal hypoglycemia: A systematic review and design of an optimal future study. Pediatrics 2006; 117:2231-43.

3. Sweet CB, Grayson S, Polak M. Management Strategies for Neonatal Hypoglycemia. J Pediatr Pharmacol Ther 2013; 18(3):199-208.

4. Heck LJ, Erenberg A. Serum glucose levels in term neonates during the first 48 hours of life. J Pediatrics 1987;110(1):119-22.

5. Tanzer F, Yazar N, Yazar H, Icagansioglu D. Blood glucose levels and hypoglycemia in full term neonates during the first 48 hours of life. J Tropical Pediatrics 1997;43:58-60.

6. Pal DKManandhar DSRajbhandari S, Land JMPatel Nde L Costello AM. Neonatal hypoglycaemia in Nepal: Prevalence and risk factors. Arch Dis Child Fetal Neonatal Ed 2000; 82(1):46-51.

7. Johnston E. Tasker R, McClure R, Acerini C. Oxford Handbook of Paediatrics. 2nd ed. Oxford: Oxford University Press; 2013. P. 132.

8.  Cornblath M, Ichord R. Hypoglycemia in the neonate. Semin Perinatol. 2000;24(2): 136-49

9. Rozance P, Hay W. Hypoglycemia in newborn infants: features associated with adverse outcomes. Biol Neonate 2006; 90(2):74-86.

10.  Hawdon J, Ward Platt M, Aynsley-Green A. Patterns of metabolic adaptation for preterm and term infants in the first neonatal week. Arch Dis Child 1992; 67(4):357-65

11. Kalhan S, Parmimi P. Gluconeogenesis in the fetus and neonate. Semin Perinatol 2000; 24(2):94-106.

12. Vadakekut ES1, McCoy SJPayton ME. Association of maternal hypoglycemia with low birth weight and low placental weight: a retrospective investigation. J Am Osteopath Assoc 2011; 111(3):148-52.

13. Jones G. Twins and Higher Multiple Gestations. In: Baker PN, Kenny LC,editors. Obstetrics by ten teachers.19th ed. London: Hodder & Stoughton Ltd; 2011. P. 109

14. Simonsen SE, Varner MW. Grand-Multiparity. Accessed May,2016 at

15. Fenton TR, Kim JH. A systematic review and meta-analysis to revise the Fenton growth chart for preterm infants. BMC Pediatr 2013;13:59.

16. Holtrop P. The frequency of hypoglycemia in full term and small for gestational age newborns. Am J Perinatol 1993; 10:150-4.

17.   Ayoub N, Hanoudi BM, Naif MH. Evaluation of Maternal and Neonatal Risk factors for Neonatal Hypoglycemia. Iraqi J Comm Med 2013; 1:13-8.

18. Schaefer-Graf UMRossi RBührer CSiebert GKjos SLDudenhausen JW, et al. Rate and risk factors of hypoglycemia in large- for-gestational-age newborn infants of non diabetic mothers. Am J Obstet Gynecol 2002; 187(4):913-7.

19.  DePuy AMCoassolo KMSom DASmulian JC. Neonatal hypoglycemia in term, nondiabetic pregnancies. Am J Obstet Gynecol 2009; 200(5):45-51.

20. de Freitas Pde Matos CVKimura AF.Profile of mothers of newborns with blood glucose control in the first hours of life. Rev Esc Enferm USP 2010; 44(3):636-41.

21.  Ogunyemi DFriedman PBetcher KWhitten ASugiyama NQu L, et al. Obstetrical Correlates and Perinatal Consequences of Neonatal Hypoglycemia in Term Infants. J Matern Fetal Neonatal Med 2016; 17:1-16.

22. Zanardo VCagdas SMarzari F. Factors associated with neonatal hypoglycemia in premature twins and singletons. Acta Genet Med Gemellol (Roma)  1997; 46(1):69-77.

23. Haninger NC, Farley CL. Screening for hypoglycemia in healthy term Neonates: effects on breastfeeding. J Midwifery Womens Health 2001; 46(5):292-301.