Hypoglycemia: What is it for the neonate?

The definition of hypoglycemia in the newborn infant has remained controver sial because of lack of significant correlation between plasma glucose conc entration, clinical symptoms, and long-term sequelae. A threshold value for plasma glucose at which clinical intervention should be considered is impo rtant because of the potential for serious neurological injury. In this rev iew, we have described threshold values for plasma glucose in the newborn i nfant, based upon available data, at which the clinician should consider cl ose monitoring and therapeutic interventions aimed at increasing the glucos e level. In clinically symptomatic infants, plasma glucose concentrations o f 45 mg/dL (2.5 mmol/L) or less should be considered as threshold for inter vention. In an asymptomatic baby and in those at risk for hypoglycemia, irr espective of gestational and postnatal age, plasma glucose values less than 36 mg/dL (2.0 mmol/L) should be considered as threshold levels. Variances from these criteria, as in breast-fed infants, are discussed. The threshold values described for surveillance and intervention should be separated fro m the targeted therapeutic values which should be in the range of 72-90 mg/ dL (4-5 mmol/L).