The prevalence and causes of hyperglycemia in newborns Original Article

Yıl 2008, Cilt: 43 Sayı: 2, 55 - 58, 01.06.2008

Yaşar Şen Neşe Çıtak Kurt Yaşar Doğan Saadet Akarsu A. Denizmen Aygün

Öz

Aim: The prospective study was performed to determine the prevalence and risk factors of hyperglycemia to newborns admitted in the neonatal unit nbsp; nbsp; nbsp; Material and Method: The newborns that had blood glucose levels gt;150 mg dl and referred to the Neonatal Unite Medical Center of Firat University between January 1 July 1 2007 were enrolled in the study Prenatal natal and postnatal histories examination and laboratory findings glucose infusion rates other diseases diagnosed and treatments received duration of hyperglycemia and prognosis of newborns with hyperglycemia were assessed Results: The prevalence of neonatal hyperglycemia was 2 9 during the study period Its prevalence rates were 4 5 5 2 6 5 13 9 and 30 8 respectively in newborns receiving parenteral glucose infusion preterm low birthweight very low birthweight and extremely low birthweight infants The mean diagnosis age mean gestational age and mean birth weight of those hyperglycemic neonates were 4 2±4 1 days 33 2±5 1 weeks and 2248 46±1450 62 g respectively The mean blood glucose level and mean intravenous glucose rate at the time of diagnosis was 398 53±170 mg dl and 4 8±2 0 mg kg min respectively The mean duration of hyperglycemia was 15 8±10 8 hours The most important risk factors associated with neonatal hyperglycemia were maturity birth asphyxia respiratory distress syndrome and sepsis respectively Conclusions: Hyperglycemia has become a significant risk factor for morbidity and mortality during the neonatal period The prevalence of hyperglycemia increases in newborn babies as the birthweight and gestational age of neonates decrease Blood glucose levels should be monitored daily in all infants who receive intravenous glucose infusions until blood glucose concentration becomes stable Turk Arch Ped 2008; 43: 55 8 Key words: Hyperglycemia newborn premature small gestational age

Anahtar Kelimeler

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Yenidoğanlarda hiperglisemi sıklığı ve nedenleri Orijinal Araştırma

Öz

Amaç: Yenidoğan bebeklerde hiperglisemi sıklığını ve gelişiminde etkili olan etmenleri ortaya koymak Gereç ve Yöntem: Çalışmaya 1 Ocak 1 Temmuz 2007 tarihleri arasında Fırat Üniversitesi Fırat Tıp Merkezi Yenidoğan Birimi’nde plazma glükoz düzeyi 8805;150 mg dl bulunan yenidoğanlar kabul edildi Olguların doğum öncesi doğum sırası doğum sonrasındaki özellikleri fizik muayene ve laboratuvar bulguları glükoz enfüzyon hızları aldıkları diğer tanıları tedavileri ve seyirleri kaydedildi Bulgular: Çalışma süresince izlenen toplam 435 hastadan 13’ünde 2 9 hiperglisemi tespit edildi Bu oran parenteral sıvı alan yenidoğanlarda 4 5’e ulaştı Hiperglisemi sıklığı erken doğmuş bebeklerde 5 2 düşük doğum ağırlığı olanlarda 6 5 çok düşük doğum ağırlıklılarda 13 9 ve aşırı derecede düşük doğum ağırlığı olanlarda ise 30 8 bulundu Hiperglisemili olguların tanı alma yaşı 4 2±4 1 gün gebelik haftası 33 2±5 1 hafta ve doğum ağırlıkları 2 248 46±1 450 62 gram idi Tanı anında ortalama plazma glükoz düzeyi 3 98 53±1 70 19 mg dl iken damardan glükoz enfüzyon hızı 4 8±2 0 mg kg dak bulundu Kan glükoz düzeyleri yaklaşık 15 8±10 8 saatte normale döndü Hiperglisemili olgularda hiperglisemiye eşlik eden sorunların başında erken doğum doğum asfiksisi respiratuvar distres sendromu ve sepsis gelmekteydi Çıkarımlar: Hiperglisemi yenidoğanlarda hastalanma ve ölüm açısından önemli bir risk etmeni olarak kabul edilmektedir Yenidoğan bebeklerde doğum ağırlığı ve gebelik haftası azaldıkça hiperglisemi sıklığı artmaktadır Damardan glükoz enfüzyonu uygulanan tüm bebeklerin glükoz düzeyleri sabit olana kadar kan glükoz düzeyleri yakından takip edilmelidir Türk Ped Arş 2008; 43: 55 8 Anahtar kelimeler: Düşük doğum ağırlığı erken doğmuş hiperglisemi yenidoğan

Anahtar Kelimeler

Düşük doğum ağırlığı, erken doğmuş, hiperglisemi, yenidoğan

Kaynakça

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