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In a unique perinatal cohort linking findings from early postnatal blood glucose screening to educational achievement test scores at age 10 years, Kaiser and colleagues1 in this issue of JAMA Pediatrics reignite debate over the significance of early asymptomatic, or transitional, neonatal hypoglycemia. While there is little doubt that recurrent severe hypoglycemia can cause neonatal brain injury,2 recent systematic reviews have highlighted the paucity of high-quality evidence on which to base management of early blood glucose concentrations in newborns, especially at term and late preterm gestations.3 Current practice is based largely on expert opinion, which for almost 50 years has been divided as to whether transient low glucose concentrations in otherwise healthy newborns represent normal physiological variation or a marker of inadequate metabolic adaptation, with risk of injurious neuroglycopenia.3,4
McKinlay CJD, Harding JE. Revisiting Transitional HypoglycemiaOnly Time Will Tell. JAMA Pediatr. 2015;169(10):892-894. doi:10.1001/jamapediatrics.2015.1766