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根据胎龄划分的早产儿出生后7天内的血糖水平。

Blood glucose levels within 7 days after birth in preterm infants according to gestational age.

作者信息

Yoon Ju Young, Chung Hye Rim, Choi Chang Won, Yang Sei Won, Kim Beyong Il, Shin Choong Ho

机构信息

Department of Pediatrics, Seoul National University Children's Hospital, Seoul, Korea.

Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, Korea.

出版信息

Ann Pediatr Endocrinol Metab. 2015 Dec;20(4):213-9. doi: 10.6065/apem.2015.20.4.213. Epub 2015 Dec 31.

Abstract

PURPOSE

This study investigated blood glucose levels in preterm babies according to gestational age (GA).

METHODS

Subjects were 141 preterm infants with a GA<34 weeks. Data on blood glucose levels, GA, body weight, glucose infusion rate, and other contributing factors in the first 7 days after birth were analyzed. Hypoglycemia was defined as a blood glucose level of <40 mg/dL up to 24 hours after birth and as <50 mg/dL thereafter. Hyperglycemia was defined as a blood glucose level >180 mg/dL.

RESULTS

During the 7 days after birth, hypo- and hyperglycemia occurred in 29 (29 of 141, 20.6%) and 42 (42 of 141, 29.8%) neonates, respectively. During the first 2 hours, 18 neonates (12.8%) exhibited hypoglycemia, and only 2 (2 of 141, 1.4%) developed hyperglycemia. From 6 to 24 hours, hypo- and hyperglycemia were observed in 0 and 9 (9 of 141, 6.4%) neonates, respectively. Infants small for their GA (SGA) were at risk for hypoglycemia both within 24 hours (odds ratio [OR], 2.718; P=0.045) and during days 2 to 7 (OR, 4.454; P=0.006), and hyperglycemia during days 2 to 7 (OR, 3.200; P=0.005). Low 1-minite Apgar score was risk factor for both hypo- and hyperglycemia during days 2 to 7 (OR, 0.756; P=0.035 for hypoglycemia and OR, 0.789; P=0.016 for hyperglycemia). Both hypo- and hyperglycemia within 24 hours were less common in those who started feeding (OR, 0.294; P=0.013 for hypoglycemia and OR, 0.162; P=0.011 for hyperglycemia).

CONCLUSION

Careful blood glucose level monitoring is required in preterm infants, especially SGA infants or those with low Apgar score. Early feeding could be beneficial for maintaining euglycemia.

摘要

目的

本研究根据胎龄(GA)调查早产儿的血糖水平。

方法

研究对象为141例GA<34周的早产儿。分析出生后前7天的血糖水平、GA、体重、葡萄糖输注速率及其他相关因素的数据。低血糖定义为出生后24小时内血糖水平<40mg/dL,之后为<50mg/dL。高血糖定义为血糖水平>180mg/dL。

结果

出生后7天内,分别有29例(141例中的29例,20.6%)和42例(141例中的42例,29.8%)新生儿发生低血糖和高血糖。出生后前2小时,18例新生儿(12.8%)出现低血糖,仅2例(141例中的2例,1.4%)发生高血糖。出生后6至24小时,分别有0例和9例(141例中的9例,6.4%)新生儿出现低血糖和高血糖。小于胎龄儿(SGA)在出生后24小时内(比值比[OR],2.718;P=0.045)和出生后第2至7天(OR,4.454;P=0.006)有发生低血糖的风险,在出生后第2至7天有发生高血糖的风险(OR,3.200;P=0.005)。1分钟Apgar评分低是出生后第2至7天发生低血糖和高血糖的危险因素(低血糖的OR,0.756;P=0.035;高血糖的OR,0.789;P=0.016)。出生后24小时内开始喂养的新生儿发生低血糖和高血糖的情况均较少见(低血糖的OR,0.294;P=0.013;高血糖的OR,0.162;P=0.011)。

结论

早产儿,尤其是SGA婴儿或Apgar评分低的婴儿,需要仔细监测血糖水平。早期喂养可能有助于维持血糖正常。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/854f/4722161/dcc0fb5fbde8/apem-20-213-g001.jpg

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