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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

MCN, American Journal of Maternal Child Nursing: September/October 2010 - Volume 35 - Issue 5 - p 264–270
doi: 10.1097/NMC.0b013e3181e4a739
Feature Article

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.

Do you know the guidelines for PBG screening for newborns? Does your institution do this routinely on all newborns? These nurses wanted to find out if such screening is necessary, and they did research to answer that question.

Debra Hoops, BSN, RN, CPST, is a Clinical Educator at Women and Children's service line on the Mother—Baby Unit, Saint Luke's Hospital of Kansas City, Kansas City, Missouri.

Patrice Roberts, BSN, RN, CE, Principal Investigator, is a Clinical Educator for the Women's & Children's services line and the Mother—Baby Follow-up Phone Call Coordinator, Saint Luke's Hospital of Kansas City, Kansas City, Missouri. She can be reached at patroberts@saint-lukes.org.

Patrice Roberts, BSN, RN, CE, Elizabeth Van Winkle, BSN, RN, CBE, Kelly Trauschke, BSN, RN, CBE, Nicole Mauton, BSN, RN, CBE, Susan DeGhelder, MS, RN, Angela Scalise, BSN, RN, CPST, Sarah Jackson, BSN, RN, Deborah Cato, BSN, RN, Christina Roth, BSN, RN, Anna Jones, BSN, RN, CBE, CHT, Martina Kautz, BSN, RN, CBE, and Leah Whaley, RN are all Staff Nurses at Mother—Baby Unit, Saint Luke's Hospital of Kansas City, Kansas City, Missouri.

© 2010 Lippincott Williams & Wilkins, Inc.