Racial differences in neonatal hypoglycemia among very early preterm births

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.