Hypocalcaemic Tetany Developing Within

Introduction Paediatric literature contains many brief references to the occurrence of neonatal tetany. Clinical signs developed in the first week of life in only a small proportion of the recorded cases. The number of infants reported as showing signs of hypocalcaemic tetany within a few hours of birth is extremely small. Willi (1939) described eight and Bakwin (1937) four babies in whom tetany developed on the first day of life. In a more recent comprehensive study of the causes of tetany in infancy and childhood Gribetz (1957) uses the term 'first day tetany' when referring to the biochemical imvestigations of Gittleman and his co-workers. Gittleman, Pincus, Schmerzler and Saito (1956) made a special study of calcium levels on the first day of life and found low serum calcium levels with significant frequency in premature infants and in babies born at term to mothers with a history of abnormal pregnancy and/or labour. In October, 1956, the occurrence of violent neuromuscular hyperexcitability in the day-old baby of a diabetic mother in the Leeds Maternity Hospital aroused suspicions of tetany. The baby's serum calcium was 6 2 mg. per 100 ml. Within a period of one month similar findings were encountered in the newly born babies of two other mothers with diabetes mellitus. A detailed clinical study of babies newly born to diabetic mothers was commenced. As the study proceeded a resemblance was noted between the movement pattern in these babies and that seen in a number of newly born premature infants of healthy mothers. The resemblance was one of quality rather than severity. Low serum calcium levels were obtained in a high proportion of the premature babies with neuromuscular hyperactivity. A decision was therefore made to extend the investigation to include all babies manifesting neuromuscular hyperexcitability shortly after birth.