PDF(Pubmed)
Abstract：
Over 25 years ago, the World Health Organization (WHO) acknowledged the importance of effective prevention, detection and treatment of neonatal hypoglycaemia, and declared it to be a global priority. Neonatal hypoglycaemia is common, linked to poor neurosensory outcomes and, if untreated, can cause seizures and death. Neonatal mortality in low and lower-middle income countries constitutes an estimated 89% of overall neonatal deaths. Factors contributing to high mortality rates include malnutrition, infectious diseases, poor maternal wellbeing and resource constraints on both equipment and staff, leading to delayed diagnosis and treatment. The incidence of neonatal hypoglycaemia in low and lower-middle income countries remains unclear, as data are not collected.Data from high-resource settings shows that half of all at-risk babies will develop hypoglycaemia, using accepted clinical thresholds for treatment. Most at-risk babies are screened and treated, with treatment aiming to increase blood glucose concentration and, therefore, available cerebral fuel. The introduction of buccal dextrose gel as a first-line treatment for neonatal hypoglycaemia has changed the care of millions of babies and families in high-resource settings. Dextrose gel has now also been shown to prevent neonatal hypoglycaemia.In low and lower-middle income countries, there are considerable barriers to resources which prevent access to reliable blood glucose screening, diagnosis, and treatment, leading to inequitable health outcomes when compared with developed countries. Babies born in low-resource settings do not have access to basic health care and are more likely to suffer from unrecognised neonatal hypoglycaemia, which contributes to the burden of neurosensory delay and death.
摘要：
25年前,世界卫生组织（WHO）承认有效预防的重要性，新生儿低血糖的检测和治疗，并宣布这是全球优先事项。新生儿低血糖很常见，与不良的神经感觉结果有关，如果不治疗,会导致癫痫发作和死亡。低收入和中低收入国家的新生儿死亡率估计占新生儿死亡总数的89%。导致高死亡率的因素包括营养不良，传染病,孕产妇福利差，设备和工作人员资源紧张，导致延误诊断和治疗。低收入和中低收入国家新生儿低血糖的发生率仍不清楚。因为没有收集数据。来自高资源环境的数据显示，一半的高危婴儿会出现低血糖，使用公认的临床阈值进行治疗。大多数高危婴儿都会接受筛查和治疗，治疗旨在增加血糖浓度，因此,可用的大脑燃料。口腔葡萄糖凝胶作为新生儿低血糖的一线治疗的引入已经改变了数百万婴儿和家庭在高资源环境中的护理。葡萄糖凝胶现在也被证明可以预防新生儿低血糖。在低收入和中低收入国家，有相当大的资源障碍，阻止获得可靠的血糖筛查，诊断,和治疗,与发达国家相比，导致不公平的健康结果。在低资源环境中出生的婴儿无法获得基本医疗保健，更有可能患有未被识别的新生儿低血糖，这导致了神经感觉延迟和死亡的负担。
