脐带 C 肽水平在预测糖尿病母亲婴儿低血糖中的作用。

Role of umbilical cord C-peptide levels in early prediction of hypoglycemia in infants of diabetic mothers.

机构信息

Department of Pediatrics, Faculty of Medicine, Sohag University, 15 University Street, Sohag, 82524, Egypt.

Department of Obstetrics and Gynecology, Faculty of Medicine, Sohag University, Sohag, Egypt.

出版信息

BMC Pediatr. 2021 Feb 17;21(1):85. doi: 10.1186/s12887-021-02547-w.

DOI:10.1186/s12887-021-02547-w

PMID:33596873

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7888149/

Abstract

BACKGROUND

Until now, diabetes during pregnancy has been associated with a high risk of maternal, fetal, and neonatal morbidities and mortalities. The main aim of this study was to evaluate the risk factors of hypoglycemia in infants of diabetic mothers (IDMs) and to study the relationship between umbilical cord (UC) C peptide levels and the risk of developing hypoglycemia.

MATERIAL AND METHODS

UC blood C-peptide and serial serum blood glucose measurements were done for all included singleton newborns born to diabetic mothers during the study period. Maternal and neonatal data such as gestational age, maternal age, maternal weight, types of diabetics and its control, maternal glycated hemoglobin (HbA1C), birth weight, Apgar score, and neonatal complete blood picture were collected.

RESULTS

In total, 83 IDMs met the inclusion criteria. Fifty-four (65.06%) developed hypoglycemia and 29 (34.94%) remained normoglycemic. However, there were no significant differences between hypoglycemic and normoglycemic IDMs in terms of types of maternal diabetics (P value = 0.41), its duration (P value = 0.43). The hypoglycemia peak occurred within the first 3 h of life, with 33.11 ± 8.84 mg/dl for the hypoglycemia group and 54.10 ± 6.66 mg/dl for the normoglycemic group (P value < 0.0001). Most of the babies had no hypoglycemic manifestation (96.30%). Neonates with hypoglycemia their mothers had poor diabetes control in the last trimester (HbA1C 7.09 ± 0.96%) compared to normoglycemic babies (HbA1C 6.11 ± 0.38%), (P-value < 0.0001). The mean (SD) of UC C-peptide level in hypoglycemic neonates increased to 1.73 ± 1.07 ng/ml compared to normoglycemic ones with 1.08 ± 0.81 ng/ml (P value = 0.005).

CONCLUSION

Poor diabetes control, especially in the last trimester, is associated with neonatal hypoglycemia. Increased UC C-peptide levels could be used as an early indicator for the risk of developing neonatal hypoglycemia and a predictor for babies need neonatal admission.

摘要

背景

直到现在，妊娠糖尿病仍与母婴、胎儿和新生儿发病率和死亡率高有关。本研究的主要目的是评估糖尿病母亲婴儿（IDM）低血糖的危险因素，并研究脐带（UC）C 肽水平与发生低血糖风险之间的关系。

材料和方法

在研究期间，对所有单胎糖尿病母亲所生的新生儿均进行 UC 血 C 肽和连续血清血糖测量。收集了产妇和新生儿数据，如胎龄、产妇年龄、产妇体重、糖尿病类型及其控制情况、产妇糖化血红蛋白（HbA1C）、出生体重、阿普加评分和新生儿全血细胞计数。

结果

共有 83 名 IDM 符合纳入标准。54 名（65.06%）发生低血糖，29 名（34.94%）血糖正常。然而，在低血糖和血糖正常的 IDM 之间，母亲患糖尿病的类型（P 值=0.41）及其持续时间（P 值=0.43）无显著差异。低血糖的峰值出现在生命的前 3 小时内，低血糖组为 33.11±8.84mg/dl，血糖正常组为 54.10±6.66mg/dl（P 值<0.0001）。大多数婴儿没有低血糖表现（96.30%）。与血糖正常的婴儿相比，低血糖婴儿的母亲在妊娠晚期的糖尿病控制较差（HbA1C 7.09±0.96%），而血糖正常的婴儿（HbA1C 6.11±0.38%）（P 值<0.0001）。低血糖新生儿的 UC C 肽水平平均值（SD）增加至 1.73±1.07ng/ml，而血糖正常新生儿的 UC C 肽水平平均值（SD）为 1.08±0.81ng/ml（P 值=0.005）。