hypoglycemia in sick preterm infants and the therapeutic effect of 12.5% dextrose in water compared with 10% dextrose in water

neonatal hypoglycemia is common and its prompt ‎management is important to reduce neurological sequelae. to determine the effect of two different glucose concentrations of intravenous (iv) fluid ‎therapy in the incidence of hypoglycemia in sick premature infants, 200 preterm infants ‎weighing 1500-2500 g were selected and randomly assigned into two groups. ‎group 1 received 10% dextrose in water (dw) and for group 2 ‎we used 12.5% dw with recommended fluid volume according to the infant’s condition. ‎first blood glucose sample ‎was obtained during 2-3 hours of life before starting iv therapy and the two others were ‎measured between 4-24 hours of life after starting iv fluid therapy. plasma glucose < 36 mg/dl during 2-3 hours of life and level below ‎45 mg/dl between 4-24 hours of life were considered as hypoglycemia. ‎birth weight, gestational age and type of diseases in two groups were matched. although ‎there was no difference between volume of fluid, statistical differences were found to ‎be significant between amounts of calories (p = 0.000) and dextrose (p = 0.000) received ‎in two groups. we detected 15 and 30 cases of hypoglycemia in group 1 and 2, ‎respectively. after starting iv fluid therapy, the incidence of hypoglycemia decreased especially in ‎group 2 and comparison of cases with two consecutive low plasma glucose in two ‎groups showed significant difference (p= 0.024, relative risk= 2.67). ‎we recommend 12.5% dw when initiation of peripheral iv therapy is indicated in sick ‎preterm infants weighing 1500-2500 g, especially when restriction of fluid is mandated.