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MCN, American Journal of Maternal Child Nursing:
doi: 10.1097/NMC.0b013e3181e4a739
Feature Article

Should Routine Peripheral Blood Glucose Testing Be Done for All Newborns at Birth?

Hoops, Debra BSN, RN, CPST; Roberts, Patrice BSN, RN, CE; Winkle, Elizabeth Van BSN, RN, CBE; Trauschke, Kelly BSN, RN, CBE; Mauton, Nicole BSN, RN, CBE; DeGhelder, Susan MS, RN; Scalise, Angela BSN, RN, CPST; Jackson, Sarah BSN, RN; Cato, Deborah BSN, RN; Roth, Christina BSN, RN; Jones, Anna BSN, RN, CBE, CHT; Kautz, Martina BSN, RN, CBE; Whaley, Leah RN

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Abstract

Purpose: To determine the (1) incidence of peripheral blood glucose (PBG < 40 mg/dL) in infants within 2 hours of birth and (2) validity of using maternal and infant risk factors and/or infant signs/symptoms of hypoglycemia as a screen for PBG < 40 mg/dL.

Study Design: Descriptive study with a convenience sample of 220 mother–infant dyads admitted to a mother–baby unit. Maternal and infant risk factors and infant signs/symptoms of hypoglycemia were assessed, and a PBG value was obtained within 2 hours of birth from the infant. Data were analyzed with descriptive statistics, multiple regression analysis, and sensitivity and specificity testing.

Results: The incidence of PBG < 40 mg/dL was 5.1% (N = 10 of 198). Fifteen maternal/infant risk factors were found; 2 of the 23 risk factors predicted PBG values within 2 hours of birth at a statistically significant level (jitteriness [p = .011] and tachypnea [p = .033]). Sensitivity was 71.9% and specificity 44.7% for using the presence of at least one maternal/infant risk factor and/or infant signs/symptoms of hypoglycemia to correctly identify PBG < 40 mg/dL within 2 hours of birth.

Clinical Implications: Nurses working with mothers and infants can use the data from our study along with the recommendations from professional organizations such as American Academy of Pediatrics to begin a conversation at their institutions about revising protocols for routine PBG testing. Screening infants for maternal/infant risk factors and infant signs/symptoms of hypoglycemia could be used instead to safely decrease by 45% the number of infants who would need to have a PBG sample obtained within 2 hours of birth.

© 2010 Lippincott Williams & Wilkins, Inc.

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