Hypoglycemia on Admission, Associated Factors, and Early Outcome Among Neonates Admitted to the Neonatal Unit at Muhimbili National Hospital

Background Neonatal hypoglycemia is a significant metabolic disturbance contributing to neonatal morbidity and mortality. This study aimed to assess the prevalence, associated factors, management practices, and early outcomes of hypoglycemia among neonates admitted to Muhimbili National Hospital (MNH), Tanzania. Methods A prospective cross-sectional study was conducted at MNH from November 2024 to April 2025, enrolling 130 neonates aged 0–28 days. Hypoglycemia was defined as a random blood glucose level < 2.6 mmol/L. Data were collected using structured questionnaires and glucometer readings. Statistical analysis included chi-square tests to identify factors associated with hypoglycemia. Results Of the 130 neonates, 28.5% (n = 37) were hypoglycemic. Significant risk factors included prematurity (p = 0.030), low birth weight, macrosomia (p = 0.004), delayed or absent feeding (p = 0.001), and maternal diabetes (p = 0.001). Most hypoglycemic neonates were managed via oral feeding or intravenous dextrose. Poor outcomes such as persistent hypoglycemia (n = 9), partial recovery (n = 3), and death (n = 3) were more common among hypoglycemic neonates (p = 0.001). Conclusions Neonatal hypoglycemia remains a prevalent and serious concern at MNH, especially among high-risk groups. Early glucose monitoring, timely feeding, and integration of cost-effective interventions like dextrose gel are essential to improving neonatal outcomes.