Battarbee Ashley N, Anderson Sarah B, Tita Alan T N, Harper Lorie M
Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
Department of Obstetrics and Gynecology, UC Health Memorial Hospital Central, Colorado Springs, Colorado.
Am J Perinatol. 2020 Nov;37(13):1351-1356. doi: 10.1055/s-0039-1693717. Epub 2019 Jul 31.
The objective of this study was to evaluate the association between the method of maternal glycemic control after antenatal corticosteroid, administration and maternal hyperglycemia and neonatal morbidity among women with diabetes.
This was a retrospective cohort study of women with pregestational diabetes who received antenatal corticosteroids and delivered in <34 weeks. The primary maternal outcome was adequate glycemic control, defined as <50% of glucose values above goal (fasting <100 mg/dL, 2-hour postprandial <120 mg/dL, or <115 mg/dL on insulin infusion). The primary neonatal outcome was composite morbidity (continuous positive airway pressure, mechanical ventilation, intraventricular hemorrhage, or death). Demographic characteristics and outcomes were compared by the method of glycemic control and neonatal morbidity using chi-square test, Fisher's exact test, Mann-Whitney -test, and Student's -test, as appropriate.
Of 52 eligible women, only 1 (1.9%) had adequate maternal glycemic control. There was no significant association between the method of glycemic control and maternal hyperglycemia or neonatal morbidity. There was no association between maternal glucose and neonatal morbidity; however, neonates with composite morbidity were more likely to be born to women who received less insulin.
Maternal glycemic control among women with diabetes was poor after the antenatal corticosteroid administration, regardless of glycemic control method. Neither the method of maternal glycemic control nor the degree of control was associated with neonatal morbidity.
本研究的目的是评估糖尿病女性产前使用糖皮质激素后母亲血糖控制方法与母亲高血糖及新生儿发病率之间的关联。
这是一项对患有孕前糖尿病且接受产前糖皮质激素治疗并在34周前分娩的女性进行的回顾性队列研究。母亲的主要结局是血糖控制良好，定义为高于目标值的血糖值占比<50%（空腹<100mg/dL，餐后2小时<120mg/dL，或胰岛素输注时<115mg/dL）。新生儿的主要结局是复合发病率（持续气道正压通气、机械通气、脑室内出血或死亡）。根据血糖控制方法和新生儿发病率，酌情使用卡方检验、Fisher精确检验、Mann-Whitney检验和Student检验对人口统计学特征和结局进行比较。
在52名符合条件的女性中，只有1名（1.9%）母亲血糖控制良好。血糖控制方法与母亲高血糖或新生儿发病率之间无显著关联。母亲血糖与新生儿发病率之间无关联；然而，患有复合发病率的新生儿更有可能出生于胰岛素使用量较少的女性。
无论血糖控制方法如何，糖尿病女性在产前使用糖皮质激素后母亲血糖控制都很差。母亲血糖控制方法和控制程度均与新生儿发病率无关。
