<b>Incidence of Asymptomatic Hypoglycemia in Full-Term Low-Birth-Weight Babies Versus Full-Term Normal-Birth-Weight Babies</b>

Background: Early neonatal hypoglycemia is a common metabolic problem and may remain clinically silent, particularly in neonates with reduced metabolic reserves. Full-term low-birth-weight neonates may be vulnerable despite term gestation, but local comparative data remain limited. Objective: To compare the incidence of asymptomatic hypoglycemia during the first four hours of life between full-term low-birth-weight and full-term normal-birth-weight neonates. Methods: This prospective comparative cohort study was conducted in the Department of Pediatrics, Ali Fatima Hospital, Lahore, Pakistan, from September 12, 2024, to March 12, 2025. Sixty full-term neonates were enrolled by consecutive sampling and divided into low-birth-weight and normal-birth-weight groups, with 30 neonates in each group. Blood glucose was measured by heel-prick capillary sampling during the first four hours of life. Asymptomatic hypoglycemia was defined as blood glucose <55 mg/dL. Data were analyzed using SPSS version 25. Results: The mean gestational age was 37.73 ± 0.75 weeks, and the mean birth weight was 2.59 ± 0.41 kg. Overall, asymptomatic hypoglycemia occurred in 21 neonates (35.0%). Hypoglycemia was more frequent in low-birth-weight neonates than in normal-birth-weight neonates, occurring in 16/30 (53.3%) and 5/30 (16.7%), respectively. The crude relative risk was 3.20, with an absolute risk difference of 36.7 percentage points. Conclusion: Full-term low-birth-weight neonates had a higher incidence of early asymptomatic hypoglycemia than normal-birth-weight neonates, supporting early glucose screening in this risk group