Endocrine Abstracts

JOINT3729

Introduction: Neonatal hypoglycaemia is the most common metabolic condition in neonates. It affects up to 15% of all neonates and 50% of neonates born with risk factors. However, there is still no international consensus on treatment thresholds and management strategies for neonatal hypoglycaemia. In March 2020, a new standard operating procedure (SOP) for the "early detection and treatment of neonatal hypoglycaemia" for newborns born after 35 weeks of gestation was introduced at the Paediatric and Obstetric Clinic of the University Hospital Düsseldorf. The development of this SOP was based on an extensive review of various international guidelines. The SOP provides a preventative approach for children with risk factors for neonatal hypoglycaemia and includes standardised blood glucose screening and treatment of hypoglycaemia if necessary. The aim of this study is to compare a retrospective (pre-SOP) and a prospective (post-SOP) cohort to investigate whether the SOP has improved the early detection and management of hypoglycaemia and whether the number of severe or prolonged hypoglycaemia has decreased. It will also compare the frequency of hypoglycaemia, the number of blood glucose measurements, the rate of transfer to the paediatric clinic, the duration of treatment with intravenous glucose, and the overall inpatient treatment.

Methods: The study includes a total of 607 children born at the University Children’s Hospital Düsseldorf, 280 born before to the implementation of the new SOP (before March 2020) and 327 born after the implementation of the new SOP. The cohorts were matched for sex, birth weight, gestational age, and risk factor for neonatal hypoglycaemia.

Results: All patients have been enrolled in the study. Data collection is currently being completed. We then plan to perform statistical analyses and present the final data at the conference.

Conclusion: Given the high incidence of hypoglycaemia in neonates, it is of great interest to determine whether the new standard can detect hypoglycaemia more frequently, prevent profound hypoglycaemia, reduce the number of severe and prolonged hypoglycaemic episodes and thus prevent possible negative consequences due to brain damage. However, the ’costs’ of interventions also need to be analysed, including patients who have received interventions but are unlikely to have benefited from them. It is only through such analyses that evidence-based guidelines can be developed, which is urgently needed for an issue as important as neonatal hypoglycaemia to improve the approach for future generations.