Abstract
Objective:
To determine whether the prevalence of neonatal hypoglycemia differs by race/ethnicity.
Study design:
A retrospective cohort study using prospectively collected data from 515 neonates born very preterm (<32 weeks) to normoglycemic women and admitted to the neonatal intensive care unit (NICU) at a major tertiary hospital in Boston, MA, between 2008 and 2012.
Results:
A total of 61%, 12%, 7%, 7%, and 13% were White, Black, Hispanic, Asian, and Other, respectively. Among the 66% spontaneous preterm births, 63% of the black neonates experienced hypoglycemia (blood glucose level < 40 mg/dL), while only 22–30% of the other racial/ethnic neonates did so (Black vs. White RR 2.15; 95% CI: 1.54–3.00). After adjusting for maternal education, maternal age, multiple gestations, delivery type, gestational age, birth weight, and neonates’ sex, this association remained significant (adjusted Black vs. White RR: 1.61, 95% CI: 1.13–2.29). An increased risk of infant hypoglycemia was not seen in infants of other racial/ethnic groups, nor in any racial/ethnic group with a medically indicated preterm birth.
Conclusions:
Black neonates delivered for spontaneous (but not medical) indications at <32 weeks had a higher risk of hypoglycemia, which could provide critical information about mechanisms of preterm birth and adverse postnatal outcomes in this high-risk group.
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Acknowledgments
We thank Dave Miedema from the Department of Neonatology at BIDMC for assistance with data extraction and management of the BIDMC NICU database. This study was supported by NIH K12HD051959 (T.J.T.), NIH R01ES026166 (T.J.T.), and NIH T32DK007699 (J.M.).
Authors contributions
J.M. and F.B. conceived of the work; T.J.T., M.M., M.G., and J.S. acquired and analyzed the data; all authors interpreted the data; all authors drafted and revised the manuscript, all authors approved the final version to be published, and all authors agreed to be accountable for all aspects of the work.
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The authors declare that they have no competing financial interest.
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Tamarra James-Todd and Melissa March contributed equally to this manuscript.
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James-Todd, T., March, M.I., Seiglie, J. et al. Racial differences in neonatal hypoglycemia among very early preterm births. J Perinatol 38, 258–263 (2018). https://doi.org/10.1038/s41372-017-0003-9
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DOI: https://doi.org/10.1038/s41372-017-0003-9