Casey Jordan R R, Banks Jennifer, Braniff Kathleen, Buettner Petra, Heal Clare
Mackay Clinical School, College of Medicine and Dentistry, James Cook University, Mackay, Queensland, Australia.
Women's Health Unit, Mackay Base Hospital, Mackay, Queensland, Australia.
Aust N Z J Obstet Gynaecol. 2019 Dec;59(6):811-818. doi: 10.1111/ajo.12966. Epub 2019 Mar 19.
Some women with diabetes in pregnancy express and store colostrum in the antenatal period for the purposes of preventing and treating neonatal hypoglycaemia.
Our primary aim was to compare rates of neonatal hypoglycaemia in babies born to mothers who express and store antenatal colostrum to babies born to mothers who do not.
Retrospective cohort study involving 357 women with diabetes in pregnancy, who had live, singleton births delivered after 36 weeks gestation, in a regional hospital in North Queensland (2014-2015). Multivariable binary logistic regression modelling identified independent characteristics associated with primary outcomes.
Eighty women (23%) expressed antenatal colostrum and 223 (62%) did not. One hundred and thirty-one babies (37%) were diagnosed with hypoglycaemia. Aboriginal and Torres Strait Islander women were less likely to express than Caucasian women (odds ratio (OR) 0.10, 95% confidence interval (CI) 0.01-0.77). There were no significant differences in the rates of hypoglycaemia, or median blood glucose levels in babies born to mothers who expressed antenatal colostrum compared to babies born to mothers who did not express. Babies born to mothers who expressed were significantly less likely to receive formula in hospital compared to babies born to mothers who did not (OR 0.12, 95% CI 0.05-0.32).
We found no independent association of expressing antenatal colostrum on rates of neonatal hypoglycaemia or median blood glucose levels. Expressing antenatal colostrum may have some benefits to the newborn such as reduced formula consumption in hospital. Further research into other methods of reducing neonatal hypoglycaemia appears warranted.
一些妊娠糖尿病女性在孕期挤出并储存初乳，目的是预防和治疗新生儿低血糖。
我们的主要目的是比较孕期挤出并储存初乳的母亲所生婴儿与未挤出并储存初乳的母亲所生婴儿的新生儿低血糖发生率。
回顾性队列研究，纳入了2014 - 2015年在北昆士兰一家地区医院分娩的357例妊娠糖尿病女性，她们均为单胎活产且孕周≥36周。多变量二元逻辑回归模型确定了与主要结局相关的独立特征。
80名女性（23%）挤出并储存了产前初乳，223名（62%）未挤出。131名婴儿（37%）被诊断为低血糖。与白人女性相比，原住民和托雷斯海峡岛民女性挤出并储存初乳的可能性更小（优势比（OR）0.10，95%置信区间（CI）0.01 - 0.77）。与未挤出并储存初乳的母亲所生婴儿相比，挤出并储存初乳的母亲所生婴儿的低血糖发生率及血糖中位数水平无显著差异。与未挤出并储存初乳的母亲所生婴儿相比，挤出并储存初乳的母亲所生婴儿在医院接受配方奶喂养的可能性显著更低（OR 0.12，95% CI 0.05 - 0.32）。
我们发现孕期挤出并储存初乳与新生儿低血糖发生率或血糖中位数水平之间无独立关联。孕期挤出并储存初乳可能对新生儿有一些益处，如减少医院内配方奶的摄入量。对其他降低新生儿低血糖的方法进行进一步研究似乎很有必要。
