A Review of Screening Guidelines for Hypoglycaemia in Infants Born Small for Gestational Age Showed Numerous Differences and Few Certainties.

Abstract

Aim: Different hypoglycaemia screening guidelines for infants born small for gestational age (SGA) are applied throughout the world. This narrative review analysed the published guidelines and evaluated the characteristic features of hypoglycaemia in SGA infants to assess the relevance of the issue.

Methods: PubMed and the Cochrane Database of Systematic Reviews were reviewed for papers regarding hypoglycaemia and hypoglycaemia screening guidelines in term and near-term SGA infants. We also searched government-related websites and national healthcare institution websites for guidelines.

Results: Numerous differences among guidelines were found. The American Academy of Pediatrics and the Pediatric Endocrine Society do not specify which SGA infants need screening. Other guidelines suggest screening infants with birth weight < 10th percentile, while still others < 2nd percentile. Depending on the growth curves, the SGA population may change. The hypoglycaemia cut-off value was another relevant variance. The duration of glucose level checks varies from the first 4-24 h of life. The reported incidence of hypoglycaemia was 12%-52%. The timing of hypoglycaemia onset was 2-6 h of life. Specific risk factors for hypoglycaemia in SGA infants were found.

Conclusion: Numerous differences were found in the hypoglycaemia guidelines for SGA infants, and further studies are needed to address strong and uniform guidance.