The research, published in PLOS Medicine and carried out by Jane Alsweiler from the University of Auckland and colleagues, investigated the optimal dose and timing for dextrose as a preventive rather than treatment for low blood glucose.
Nearly one in three infants is at risk for neonatal hypoglycaemia (low blood sugar levels), which raise a baby’s risk of impaired nervous system development.
The researchers said other than formula feeding, which can have detrimental effects on establishing breastfeeding, there are no established methods of preventing hypoglycemia in at-risk babies - those born to mothers with diabetes, delivered preterm, or with a small or large birthweight.
However, oral dextrose gel has been shown to be effective in treating neonatal hypoglycaemia once it develops.
In the new study, the researchers randomly assigned 416 babies at risk of hypoglycaemia to receive either a standard (200 mg/kg) or high (400 mg/kg) dose of dextrose gel or placebo gel, massaged into the inside of their cheeks, either once or four times after birth, before feeds.
Of 277 babies who received any dose of dextrose, 114 (41%) developed hypoglycaemia in the first 48 hours of life, compared with 72 of 138 (52%) babies who received placebo gel. (Relative risk 0.79; 95% confidence interval [CI] 0.64-0.98, p=0.03). Although the study did not find a statistically significant difference between dextrose dosing groups, the lowest risk of hypoglycemia compared to placebo was seen in babies who received one dose of 200 mg/kg dextrose (RR 0.68, 95% CI 0.47-0.99, p = 0.04).
Although rates of overall NICU admission were similar between groups, babies who received dextrose may have been less likely to be admitted for hypoglycaemia (RR 0.46, 95% CI 0.21–1.01, p= 0.05).
Additionally, rates of breastfeeding and parental satisfaction were similar between all groups and no babies developed hyperglycaemia (high blood sugar levels). The authors are currently undertaking a follow-up study of babies in the trial to investigate the effect of oral dextrose gel on long-term outcomes.
“We’re very excited about these results,” said Dr Alsweiler, a senior lecturer at the University of Auckland Medical School and paediatrician at Auckland Hospital.
“Using dextrose gel to prevent low blood sugars has the potential to stop babies being separated from their mothers in hospital and to improve their long-term development, without any disruption of breast feeding.”
The study added: “This trial is the first to demonstrate that oral dextrose gel reduces the incidence of neonatal hypoglycaemia,” the authors said, adding that “it remains to be determined if this will result in other clinically important benefits in the short term and any effects on long term health.”
Source: PLOS Medicine
“Prophylactic Oral Dextrose Gel for Newborn Babies at Risk of Neonatal Hypoglycaemia: A Randomised Controlled Dose-Finding Trial (the Pre-hPOD Study)”
Authors: Jane Marie Alsweiler, et al.