# Incidence and Determinants of Newborn Hypoglycemia Among Neonates Hospitalized in Public Hospitals of Wolaita Zone, Southern Ethiopia: A Multicentered Prospective Follow‐Up Study

## TL;DR

This study found a high rate of newborn hypoglycemia in southern Ethiopia and identified key risk factors like maternal health issues and gestational age.

## Contribution

The study provides the first evidence on neonatal hypoglycemia incidence and predictors in the Wolaita Zone of Ethiopia.

## Key findings

- The overall incidence rate of neonatal hypoglycemia was 15.47 per 1000 neonate-days.
- Maternal history of bad obstetrics and gestational diabetes were significant predictors of hypoglycemia.
- Gestational age, hypothermia, and newborn type also strongly predicted hypoglycemia.

## Abstract

Currently, neonatal hypoglycemia is one of the most frequent metabolic disorders and is associated with an increased rate of neonatal morbidity and mortality. Although neonatal hypoglycemia is a common problem among hospitalized neonates, there is limited evidence about its incidence and predictors in Ethiopia, and no studies have been done in our study area. It is critical to consider the incidence and predictors of neonatal hypoglycemia to save neonates′ lives from acute problems, long‐term neurological impairments, and death. This study is aimed at assessing the incidence and predictors of neonatal hypoglycemia among neonates admitted to Wolaita Zone health institutions′ neonatal intensive care units.

A hospital‐based prospective follow‐up study was conducted on a sample of 785 admitted eligible neonates between November 1, 2023, and June 1, 2024. The eligible neonates were included in the study consecutively. Data were collected using a pretested interview guide and checklist on sociodemographic, obstetric, and neonatal‐related risk factors of hypoglycemia. The collected data were coded, edited, and imported to STATA Version 14 from Kobo toolbox for further analysis. The Kaplan–Meier survival curve was used to determine survival time, and the log‐rank test was used to compare survival times across categorical factors. To identify predictors, both bivariable and multivariable Cox proportional hazard regression models were employed.

Among the 785 neonates included in the final analysis, the overall incidence rate of neonatal hypoglycemia during the follow‐up time was found to be 15.47 per 1000 neonate‐days (95% CI: 12.55, 19.06). Maternal history of bad obstetrics (AHR: 2.26, 95% CI: 1.29, 3.96), gestational diabetes mellitus (AHR: 2.27, 95% CI: 1.27, 4.05), gestational age (AHR: 2.88, 95% CI: 1.35, 6.18), hypothermia (AHR: 2.55, 95% CI: 1.37, 4.77), and newborn type (AHR: 4.31, 95% CI: 1.03, 8.10) were predictors of neonatal hypoglycemia.

In this study, we found a high rate of neonatal hypoglycemia. Therefore, monitoring, identifying, and managing the aforementioned predictors is important to prevent as well as to control neonatal hypoglycemia.