Article type
Abstract
Background: Neonatal hypoglycemia is common in the first few days after birth, affecting up to 30% of at-risk newborns in Aotearoa New Zealand. Approximately half of these babies may develop hypoglycemia, increasing the risk of neurocognitive impairment. Management practices for neonatal hypoglycemia vary across New Zealand, with New Zealand Europeans demonstrating lower susceptibility compared with other ethnicities.
Objective: This project aims to develop evidence-based guidelines, through the lens of health equity, for the prevention, diagnosis, and management of neonatal hypoglycemia for newborn babies.
Methods: The process involves searching for and evaluating all available evidence, conducting a qualitative study, performing a national survey, and formulating recommendations using the GRADE approach.
Results: Equity for Indigenous populations (in our context, New Zealand Māori) is integral to this research. Our governance group, led by both Māori and non-Māori co-chairs, comprises 6 interdisciplinary experts and 1 Kaiarahi (Māori counselor). The guideline panel, inclusive of Māori, Pacific Peoples, consumers, and healthcare professionals, develops evidence-based recommendations covering 8 key topics and 26 questions. Each question is scrutinized for its impact on both Māori and non-Māori babies and their whānau (family), with a focus on promoting health equity.
The topics cover cultural and parental priorities in managing neonatal hypoglycemia, including prevention, diagnosis, and monitoring strategies. We address these questions by integrating 12 systematic reviews (8 conducted by us, 4 from existing reviews), a review overview, a scoping review, 10 narrative reviews, and a national survey. However, only limited data are available for Indigenous populations, including Māori. To inform the health equity aspects of the guidelines, we undertook a qualitative study including interviews with Māori, Pacific Peoples, and Asian families (ethnicities at highest risk in New Zealand) affected by or at risk of neonatal hypoglycemia and analyzed the findings separately for each group. The results of the systematic reviews and qualitative study have been integrated into evidence-to-decision frameworks to support panel members in formulating recommendations.
Conclusions: This clinical practice guideline will include health equity–based recommendations and be available in 2024 to assist health professionals and whānau in caring for and improving health outcomes for babies at risk of hypoglycemia.
Objective: This project aims to develop evidence-based guidelines, through the lens of health equity, for the prevention, diagnosis, and management of neonatal hypoglycemia for newborn babies.
Methods: The process involves searching for and evaluating all available evidence, conducting a qualitative study, performing a national survey, and formulating recommendations using the GRADE approach.
Results: Equity for Indigenous populations (in our context, New Zealand Māori) is integral to this research. Our governance group, led by both Māori and non-Māori co-chairs, comprises 6 interdisciplinary experts and 1 Kaiarahi (Māori counselor). The guideline panel, inclusive of Māori, Pacific Peoples, consumers, and healthcare professionals, develops evidence-based recommendations covering 8 key topics and 26 questions. Each question is scrutinized for its impact on both Māori and non-Māori babies and their whānau (family), with a focus on promoting health equity.
The topics cover cultural and parental priorities in managing neonatal hypoglycemia, including prevention, diagnosis, and monitoring strategies. We address these questions by integrating 12 systematic reviews (8 conducted by us, 4 from existing reviews), a review overview, a scoping review, 10 narrative reviews, and a national survey. However, only limited data are available for Indigenous populations, including Māori. To inform the health equity aspects of the guidelines, we undertook a qualitative study including interviews with Māori, Pacific Peoples, and Asian families (ethnicities at highest risk in New Zealand) affected by or at risk of neonatal hypoglycemia and analyzed the findings separately for each group. The results of the systematic reviews and qualitative study have been integrated into evidence-to-decision frameworks to support panel members in formulating recommendations.
Conclusions: This clinical practice guideline will include health equity–based recommendations and be available in 2024 to assist health professionals and whānau in caring for and improving health outcomes for babies at risk of hypoglycemia.