Umbilical Cord Blood Glucose Concentrations and Transitional Neonatal Hypoglycemia
Authors' conclusion
The findings of this prospective cohort study suggest that UCBG parameters were not associated with subsequent TNH. However, this study provides a large, single-center, percentile-based UCBG dataset that can support future research and clinical interpretation. Very low UCBG values may help identify neonates with higher likelihood of pathologic hypoglycemia, but this requires further validation.
Study context
- Population
- Neonates (gestational age ≥35 weeks 0 days) with paired arterial and venous umbilical cord blood samples, exposed or unexposed to hypoglycemia risk factors, Düsseldorf, Germany, 2020–2022; median gestational age 39 weeks 0 days, 55.5% male
- Participants
- 598 neonates
- Exposure
- Arterial umbilical cord blood glucose (UCBG) ≤45 mg/dL vs >45 mg/dL
- Arterial UCBG ≤45 mg/dLn = 22
- Arterial UCBG >45 mg/dLn = 576reference
- Outcome
- Hypoglycemia, defined as glucose ≤45 mg/dL during postnatal screening; severe hypoglycemia <30 mg/dL
Methodological detailssingle-centre, tertiary perinatal center, Data collected May 27, 2020, to September 1, 2022; analysed March 18 to July 15, 2025
- Single-centre
- Tertiary perinatal center
- Data collected May 27, 2020, to September 1, 2022; analysed March 18 to July 15, 2025
Main finding
As reported in the abstract
Hypoglycemia (≤45 mg/dL), all neonates
188
31.4%
Severe hypoglycemia (<30 mg/dL), all neonates
22
3.7%
Maximum AUC (ROC) of all UCBG parameters for hypoglycemia; poor discriminative performance
0.64
95% CI 0.45–0.81
Observational data: associations, not effects.
Further findings
Venous-arterial UCBG level difference · birth
Severe TNH
Median
| Outcome | Arterial UCBG ≤45 mg/dL | Arterial UCBG >45 mg/dL |
|---|---|---|
| UCBG extraction rate · birth | 35.3% (IQR 27.5%–56.1%) | 18.7% (IQR 11.9%–25.0%) |
Venous-arterial UCBG level difference · birth
- Significantly higher with arterial UCBG ≤45 mg/dL
UCBG extraction rate · birth
- Significantly higher with arterial UCBG ≤45 mg/dL
Severe transitional neonatal hypoglycemia (TNH)
- Significantly higher incidence with arterial UCBG ≤45 mg/dL
UCBG values, all neonates · birth
- Median arterial UCBG
- 67 (IQR, 58-84) mg/dL
- Median venous UCBG
- 85 (IQR, 72-102) mg/dL
- Median venous-arterial difference
- 16 (IQR, 10-23) mg/dL
- Median extraction rate
- 19.0% (IQR, 12.2%-25.5%)
- Arterial UCBG ≤45 mg/dL
- 22 (3.7%)
Original publication
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