ASSESSMENT OF TRANSITIONAL HYPOGLYCEMIA INCIDENCE AND ASSOCIATED RISK FACTORS IN TERM INFANTS BORN BY CESAREAN SECTION AMONG ATHLETIC MOTHERS

Abstract

Objective: This study aims to investigate the incidence and identify the risk factors of transitional hypoglycemia in term infants born by cesarean section (CS) among athletic mothers. Methods: Data from term infants delivered via CS from athletic mothers were reviewed. Blood glucose levels were measured using a portable glucometer at 0.5 hours, 1 hour, 2 hours, 24 hours, and 48 hours post-birth. Hypoglycemia was defined as a glucose concentration below 47 mg/dL. Risk factors were analyzed from maternal and neonatal characteristics, including maternal fitness level, gestational diabetes mellitus (GDM), use of antenatal insulin, and duration of preoperative fasting. Results: Out of 406 term infants, 90 experienced transitional hypoglycemia, representing an incidence rate of 22.2%. Hypoglycemic episodes predominantly occurred within the first 2 hours post-birth. The lowest average glucose level was recorded at 1 hour post-birth (56.24±9.69 mg/dL), increasing to approximately 74.00 mg/dL by 48 hours. Significant correlations were found between neonatal hypoglycemia and factors such as gestational age, maternal GDM, antenatal insulin use, and preoperative fasting time of ≥6 hours (P<0.05). Multivariate logistic regression analysis identified maternal GDM (OR: 2.109, 95%CI: 1.228–3.623), use of antenatal insulin (OR: 10.879, 95%CI: 1.119–105.800), and extended preoperative fasting (OR: 2.262, 95%CI: 1.340–3.821) as independent risk factors for hypoglycemia. Conclusions: Term infants born by CS, particularly from athletic mothers with GDM, those who were treated with antenatal insulin, and those subjected to prolonged preoperative fasting are at increased risk of transitional hypoglycemia. Monitoring these risk factors and implementing early feeding protocols are vital to mitigate potential neurological impacts associated with neonatal hypoglycemia.