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Racial differences in neonatal hypoglycemia among very early preterm births

Journal of Perinatology volume 38, pages 258–263 (2018)Cite this article

Subjects

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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Author notes

    Authors and Affiliations

    1. Departments of Environmental Health and Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA

      Tamarra James-Todd

    2. Division of Women’s Health, Department of Medicine, Brigham and Women’s Hospital, Boston, MA, USA

      Tamarra James-Todd

    3. Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, MA, USA

      Melissa I. March

    4. Department of Obstetrics and Gynecology, University Hospitals, Cleveland, OH, USA

      Melissa I. March

    5. Department of Medicine, Massachusetts General Hospital, Boston, MA, USA

      Jacqueline Seiglie

    6. Department of Neonatology, Beth Israel Deaconess Medical Center, Boston, MA, USA

      Munish Gupta

    7. Division of Adult Diabetes, Joslin Diabetes Center, Boston, MA, USA

      Florence M. Brown

    8. Division of Endocrinology, Boston Children’s Hospital, Boston, MA, USA

      Joseph A. Majzoub

    Authors
    1. Tamarra James-Todd
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    2. Melissa I. March
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    4. Munish Gupta
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    6. Joseph A. Majzoub
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    Corresponding author

    Correspondence to Joseph A. Majzoub.

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    Competing interests

    The authors declare that they have no competing financial interest.

    Additional information

    Tamarra James-Todd and Melissa March contributed equally to this manuscript.

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    Cite this article

    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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