Hypoglycemia continues to be a common metabolic complication faced by newborns in developing countries. Both healthy and sick neonates can be affected by hypoglycemia during the first days of life. Factors placing neonates at higher risk for developing hypoglycemia are prematurity, being small or large for gestational age, perinatal stress or asphyxia, and being born to diabetic mothers.

Neonatal hypoglycemia is important because it is common and can cause brain damage. However, the blood glucose concentration and duration required to cause damage remains unclear. There was considerable variation among the centres, implying differences in decisions to intervene. The number of days on which moderate hypoglycemia occurred was strongly related to reduced mental and motor development scores at 18 months (corrected age), even after adjustment for a wide range of factors known to influence development. There are a few retrospective studies who had done assessment of neurodevelopmental outcome in children who presented with epilepsy beyond infancy secondary to neonatal hypoglycemia .There has been considerable debate over whether asymptomatic neonatal hypoglycaemia results in neurological damage.

The current study aims to compare the early adverse neurodevelopmental outcome  of neonates with asymptomatic hypoglycemia (ASH) Vs symptomatic hypoglycemia (SH) at 6 & 9-12 months of corrected gestation age. Developmental assessment will be done with Bayley Scales of Infant and Toddler Development Third Edition by single doctor certified in Bailey III. Composite adverse outcomes will be observed in both the groups (SH & ASH). Apart from the developmental assessment, we would like look into the other  co morbidities associated with neonatal hypoglycemia like aEEG abnormalities, presence of seizure disorder, tone abnormalities, vision impairment, hearing abnormalities and mortality in follow up. This is a prospective observational cohort study. Being a prospective study, it will overcome the selection bias.