Frequency of hypoglycemia among neonates presenting with fits in pediatric ward Bahawal Victoria Hospital Bahawalpur.

Abstract

Objective: To determine the frequency of hypoglycemia among neonates presenting with clinical seizures. Study Design: Cross Sectional study. Setting: Department of Pediatrics-II, Bahawal Victoria Hospital, Bahawalpur. Period: July 2025 to January 2026. Methods: Fifty-nine neonates exhibiting clinical fits were enrolled via consecutive sampling. Cases with known metabolic diseases, congenital malformations, or tetany were excluded. Point of care blood glucose was measured immediately upon seizure recognition. Hypoglycemia was operationally defined as <30 mg/dL in term or <20 mg/dL in preterm infants within 72 hours of life, and <40 mg/dL thereafter. Statistical analysis employed SPSS version 25.0. Results: The cohort comprised 57.6% males with mean birth weight 2.8±0.7 kg. Hypoglycemia was documented in 23 participants (39.0%). Preterm neonates demonstrated a higher prevalence (52.9%) compared to term infants (33.3%), though statistically non-significant (p=0.18). Hypoglycemic infants experienced significantly greater seizure frequency (3.6±1.4 vs 2.3±1.3 episodes; p=0.002) and predominantly exhibited subtle semiology (p=0.04). Prolonged hospitalization exceeding seven days correlated significantly with hypoglycemia (47.8% vs 19.4%; p=0.03). Mortality was confined to the hypoglycemic subgroup (13.0% vs 0.0%; p=0.06). Conclusion: Hypoglycemia affects approximately two-fifths of neonates presenting with seizures, significantly associating with elevated seizure frequency, subtle clinical manifestations, and extended hospital stays. Mandatory immediate glucose assessment is crucial for optimizing acute neurological management.