Incidence and risk factors for neonatal hypoglycemia among neonates admitted to the Neonatal Intensive Care Unit at Banadir Hospital, Mogadishu, Somalia: a prospective cohort.

Abstract

Background: Hypoglycemia is a common metabolic abnormality in neonates that can cause preventable death. The neonatal hypoglycemia incidence has been estimated at 1 to 5 per 1,000 live births. A lack of understanding regarding the incidence and risk factors for Hypoglycemia in Somali neonates is an important issue that needs attention. The risk of neonatal Hypoglycemia is exceptionally high in preterm, low-birth-weight neonates and neonates born to diabetic mothers. Newborns frequently experience a brief period of low blood sugar in the initial hours of life as a regular part of their physiological development. This study aimed to evaluate the incidence and factors associated with hypoglycemia in neonates in the neonatal intensive care unit at Banadir Hospital in Mogadishu, Somalia. Methodology: This was a prospective cohort study in neonates aged 0-7 days admitted to the neonatal intensive care unit of Banadir Hospital. Using a glucometer, the neonates had random blood sugar levels taken at recruitment and then every 3 hours thereafter up to 12 hours. The temperature of the neonate was recorded with each blood glucose determination. A random blood glucose level of less than 47 mg/dl was used as a cut-off point to define hypoglycemia. A structured questionnaire was also used to collect socio-demographic, maternal, and neonatal factors from the caretakers/mothers of the neonates. The data was entered and analyzed using SPSS version 20. Results: Out of 316 neonates included in the study, 27(8.5%) had hypoglycemia at a 95% CI of (5.9-12.2 %). Early breastfeeding within the first hour of life significantly reduced the odds of hypoglycemia (AOR=0.58, p=0.039), highlighting its role as a modifiable protective factor. Conversely, oligohydramnios was associated with a 31% higher likelihood of hypoglycemia (AOR=1.31, p=0.023), suggesting its utility as a clinical risk marker. Although not statistically significant, normal vaginal delivery was associated with a greater likelihood of neonatal hypoglycemia (AOR = 2.51, p = 0.099) compared to cesarean section. Conclusions: The incidence of neonatal hypoglycemia at Banadir Hospital NICU was 8.5%, which is within the global reported average for at-risk neonates. Early initiation of breastfeeding was a significantly associated protective factor, and oligohydramnios was a significant risk factor for neonatal hypoglycemia. Recommendations: Strengthen Glucose Monitoring: Neonatal units should ensure routine blood glucose monitoring, especially within the first 12 hours of admission for at-risk neonates. Early Breastfeeding Promotion: Given its protective effect, early initiation of breastfeeding (within the first hour of life) should be actively promoted and supported by healthcare providers. Institutional protocols should align with WHO's Baby-Friendly Hospital Initiative (BFHI). Antenatal Identification and Monitoring of High-Risk Pregnancies: Pregnancies complicated by oligohydramnios should prompt anticipatory planning, including enhanced glucose monitoring and nutritional support postnatally.