Study of Correlation between APGAR Scoreand Cord Blood Glucose Level of Neonates at Tertiary Care Hospital

Background: Cord blood biochemical parameter reflects the status of neonate. APGAR score following birth is used for evaluation of the neonate. There is limited data regarding the correlation between APGAR score and cord blood sugar levels.Subjects and Methods:Glucose Oxidase Peroxidase method was used for measuring cord blood sugar levels of 250 randomly selected consecutive samples. At 1 minute and 5 minutes of life the APGAR scores of the newborns were assessed by a single person in order to avoid subjective variability. The collected data was analyzed using the SPSS software. Mothers with gestational diabetes mellitus and overt diabetes were excluded from the study. Result:The mean age of the mothers in the study population was 22.86 years ± 3.465(SD). The mean blood glucose level in the maternal blood was 88.16 mg/dl ± 10.675(SD). The vaginal deliveries were 60.6% and Lower Uterine Caesarean Sections were 39.4 %. The cord blood glucose level had a mean value of 92.48 mg/dl ±21.005 (SD). The mean APGAR scores after 1 minute and 5 minutes of birth were found to be 4.82 ± 1.42(SD) and 7.01 ±1.68 (SD) respectively. Conclusion:The study showed no correlation with cord blood sugar levels and APGAR scores calculated at 1 minute and 5 minutes of life. The study found that neonates were free from complications if the cord blood sugar levels were around 87 mg/dl.

Hypoglycemia in Small-for-Dates Newborn Infants

In 24% (18 out of 76) small-for-dates a "significant" though asymptomatic hypoglycemia was demonstrated during the first six hours of life. The cord blood glucose concentration was lower in the hypoglycemic compared to that of the small-for-date normoglycemic group. In the hypoglycemic infants, the disappearance rate of glucose was significantly elevated and the lipid mobilization disturbed. It is suggested that a lack of lipids for energy metabolism increases the glucose expenditure and hence increases the risk for hypoglycemia.

Influence of Preoperative Fasting Time on Maternal and Neonatal Blood Glucose Level in Elective Caesarean Section under Subarachnoid Block

Introduction: Pre-operative fasting period is poorly monitored in developing countries though it may lead to critical consequences especially in the parturient women and their neonates.Objective: In this prospective randomized study, conducted over a period of six months, influences of pre-operative fasting time on maternal and neonatal blood glucose level in elective caesarean section under sub-arachnoid block was observed.Methods: Three equally sized (n=20) groups with different pre-operative fasting period (Group A: 4 hours, Group B: 6 hours and Group C: 7.9±1.15 hours) were taken into consideration. Maternal blood glucose level was measured on day before operation (as baseline), on day of surgery before starting infusion and just after baby delivery. Neonatal umbilical cord blood glucose just after delivery was also measured by strip method.Results: Baseline blood glucose level of group C mother was 5.41±0.43 mmol/L, whereas glucose level before starting infusion and just after deliver was 4.46±0.45 mmol/L and 4.60±0.39 mmol/L respectively. In group A and group B, these changes were not significant (p>0.05). There was marked reduction in maternal blood glucose level in group C (p<0.001). Neonatal blood glucose level was reduced in all three groups as compared to placental circulation concept (70-80% of placental flow). No mother or neonate showed critical hypoglycaemia (in mother <4.0 mmol/L and in neonate <2.5 mmol/L). Highly significant inverse correlation was observed between maternal fasting time and blood glucose before starting infusion (r= 0.706, p <0.001), and maternal blood glucose and neonatal cord blood glucose level (r= -0.937, p <0.001).Conclusion: Though, no significant correlation could be detected between maternal fasting time and neonatal blood glucose level (r= -0.196, p >0.05) neonatal blood glucose level was reduced in group C.Key words: Pre-operative fasting time; caesarean section; sub-arachnoid block; neonatal cord blood glucose DOI: 10.3329/jafmc.v6i2.7269JAFMC Bangladesh. Vol 6, No 2 (December) 2010 pp.21-24