ArticleArchives of disease in childhood. Fetal and neonatal edition2000
Neonatal hypoglycaemia in Nepal 2. Availability of alternative fuels.
Article in Archives of disease in childhood. Fetal and neonatal edition, 2000. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.
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Who cites it
7 citing papers in PubMed, 1 synthesis or guideline pooled it, 25 citations in OpenAlex.
- The global burden of neonatal hypothermia: systematic review of a major challenge for newborn survival.BMC medicine · 2013Pooled it
- Cerebral fuels within the first week of life in very preterm infants: a cohort study.Archives of disease in childhood. Fetal and neonatal edition · 2026Trial
- Relationship of neonatal hypothermia and hypoglycemia in late preterm and term born neonates.Molecular and cellular pediatrics · 2025Review
- Strategies to improve neurodevelopmental outcomes in babies at risk of neonatal hypoglycaemia.The Lancet. Child & adolescent health · 2021Review
- Temperature Monitoring Devices in Neonates.Frontiers in pediatrics · 2021Review
- Impact of early infant feeding practices on mortality in low birth weight infants from rural Ghana.Journal of perinatology : official journal of the California Perinatal Association · 2008Article
- Maternal micronutrients and fetal outcome.Indian journal of pediatrics · 2004Review
Corrections and comments
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimsTo study early neonatal metabolic adaptation in a hospital population of neonates in Nepal.
methodsA cross sectional study was made of 578 neonates, 0 to 48 hours after birth, in the main maternity hospital in Kathmandu. The following clinical and nutritional variables were assessed: concentrations and age profiles of blood glucose, hydroxybutyrate, lactate, pyruvate, free fatty acids (FFA) and glycerol; associations between alternative fuel levels and hypoglycaemia; and regression of possible risk factors for ketone availability.
resultsRisk factors for impaired metabolic adaptation were common, especially low birthweight (32%), feeding delays, and cold stress. Blood glucose and ketones rose with age, but important age effects were also found for risk factors like hypothermia, thyroid hormone activities, and feeding practices. Alternative fuel concentrations, except FFA, were significantly reduced in infants with moderate hypoglycaemia during the first 48 hours after birth. Unlike earlier studies, small for gestational age (SGA) infants had significantly higher hydroxybutyrate:glucose ratios which suggested counter regulatory ketogenesis. Hypoglycaemic infants were not hyperinsulinaemic. Regression analysis showed risk factors for impaired counter regulation which included male and large infants, hypothermia, and poorer infant thyroid function. SGA infants and those whose mothers had received no antenatal care had increased counter regulation.
conclusionsAlternative fuels are important in the metabolic assessment of neonates, and they might provide effective cerebral metabolism even during moderate hypoglycaemia. Hypoglycaemic infants generally had lower concentrations of alternative fuels through either reduced availability or increased consumption. SGA and post term infants increased counter regulatory ketogenesis with early neonatal hypoglycaemia, but hypothermia, male gender, and low infant T4 were associated with impaired counter regulation after birth.
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