Neonatal hypoglycemia is common, especially affecting infants who are large-for-gestational age (LGA), small-for-gestational age (SGA), infants of diabetic mothers, and preterm infants.
Transient blood glucose drops occur normally after birth, usually resolving within 72 hours.
Prolonged severe hypoglycemia is linked to neurological impairment; the consequences of transient mild hypoglycemia remain uncertain.
Transition of Glucose Homeostasis at Birth
Fetal glucose metabolism relies on maternal glucose via placental diffusion.
After birth, the neonate undergoes hormonal and metabolic changes to maintain glucose levels:
Increased glucagon, cortisol, and catecholamines
Reduced insulin secretion
Activation of glycogenolysis, gluconeogenesis, lipolysis, and proteolysis.
Premature infants have limited glycogen storage and immature gluconeogenesis, increasing their vulnerability.
