Keywords

Hypoglycemia, Point of care, Screening, Sensitivity, Specificity

Authors

1. Hoops, Debra BSN, RN, CPST
2. Roberts, Patrice BSN, RN, CE
3. Winkle, Elizabeth Van BSN, RN, CBE
4. Trauschke, Kelly BSN, RN, CBE
5. Mauton, Nicole BSN, RN, CBE
6. DeGhelder, Susan MS, RN
7. Scalise, Angela BSN, RN, CPST
8. Jackson, Sarah BSN, RN
9. Cato, Deborah BSN, RN
10. Roth, Christina BSN, RN
11. Jones, Anna BSN, RN, CBE, CHT
12. Kautz, Martina BSN, RN, CBE
13. Whaley, Leah RN

Abstract

Purpose: To determine the (1) incidence of peripheral blood glucose (PBG < 40 mg/dL) in infants within 2 hours of birth and (2) validity of using maternal and infant risk factors and/or infant signs/symptoms of hypoglycemia as a screen for PBG < 40 mg/dL.

Study Design: Descriptive study with a convenience sample of 220 mother-infant dyads admitted to a mother-baby unit. Maternal and infant risk factors and infant signs/symptoms of hypoglycemia were assessed, and a PBG value was obtained within 2 hours of birth from the infant. Data were analyzed with descriptive statistics, multiple regression analysis, and sensitivity and specificity testing.

Results: The incidence of PBG < 40 mg/dL was 5.1% (N = 10 of 198). Fifteen maternal/infant risk factors were found; 2 of the 23 risk factors predicted PBG values within 2 hours of birth at a statistically significant level (jitteriness [p = .011] and tachypnea [p = .033]). Sensitivity was 71.9% and specificity 44.7% for using the presence of at least one maternal/infant risk factor and/or infant signs/symptoms of hypoglycemia to correctly identify PBG < 40 mg/dL within 2 hours of birth.

Clinical Implications: Nurses working with mothers and infants can use the data from our study along with the recommendations from professional organizations such as American Academy of Pediatrics to begin a conversation at their institutions about revising protocols for routine PBG testing. Screening infants for maternal/infant risk factors and infant signs/symptoms of hypoglycemia could be used instead to safely decrease by 45% the number of infants who would need to have a PBG sample obtained within 2 hours of birth.