هيپرگليسي ثانوي به استرس در نوزادان بستري در بخش مراقبت هاي ويژه نوزادان بيمارستان امام رضا (ع ) مشهد

Hyperglycemia Due to Stress in Nicu Admissions in Imam Reza Hospital

Introduction: in newborns, hyperglycemia is more frequent than hypoglycemia and has been associated with increased mortality as well as increased incidence ofintraventricular hemorrhage. In order to determine the prevalence of stress hyperglycemia in Neonatal Intensive Care Unit (NICU) admissions, mortality rate, cause of admission and mortality this study has been done in NICU ofEmam Reza Hospital for 13 months since 1998. Material and Methods: all babies with blood sugar more than 150 mg/dl (case group) and third admission with normoglycemia (control group), were elected. Pregnancy complications, cause of admission and mortality were compared in two groups. T-student and Chi-square test did data analysis. Results: during study, 42 patients from 1430 patients who were admitted hyperglycemia (3%). No significant difference was found between two groups about age on admission, sex, gestational age and weight. The most hyperglycemic patients were involved: Asphyxia, infection and intracranial hemorrhage. The prevalance of stress hyperglycemia in neonates with low apgar score was higher than normal score, similar to neonates that undergone CPR. Stress hyperglycemia was higher with systemic acidosis. On the other hand, the severity of acidosis on hyperglycemic group was higher than control group. Significant difference was found between two groups about coagulation test. Mortality rate in hyperglycemic group was more than control group and relative risk of mortality in stress hyperglycemic patients was 1.45 times more of central. The mortality rate was correlate with serum glucose level. The most mortality rate was in asphyxic hyperglycemic patients. Conclusion: Finally we concluded that asphyxia, infection, intracranial hemorrhage history of CPR and low apgar are important stressful factors which are able to induce releasing stress hormons and following hyperglycemia during acute illness.