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糖尿病患者产前晚期应用类固醇后新生儿低血糖

Neonatal hypoglycemia after antenatal late preterm steroids in individuals with diabetes.

机构信息

Division of Maternal-Fetal Medicine, Department of Obstetrics & Gynecology, Pritzker School of Medicine, University of Chicago, Chicago, IL, USA.

Division of Maternal-Fetal Medicine, Department of Obstetrics & Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.

出版信息

J Perinatol. 2021 Dec;41(12):2749-2753. doi: 10.1038/s41372-021-01267-4. Epub 2021 Nov 13.

Abstract

OBJECTIVE

To establish whether administration of antenatal late preterm steroids to pregnant people with diabetes resulted in higher risk of neonatal hypoglycemia.

STUDY DESIGN

This is a retrospective cohort study of individuals with pre-gestational or gestational diabetes admitted between 34 0/7-36 6/7 weeks' gestation before and after introduction of an antenatal late preterm steroids protocol. The primary outcome was any neonatal blood glucose ≤ 60 mg/dL in the first 24 h of life.

RESULTS

Of 123 mother-neonate pairs, 52.8% (N = 65) delivered during the post-protocol period; 75.4% of those (N = 49) received late preterm steroids. 59.7% (N = 34) of the pre-protocol neonates and 81.5% (N = 53) of the post-protocol neonates had hypoglycemia (p = 0.008). After controlling for gestational age at delivery and mode of delivery, neonates in the post-protocol group had increased odds of hypoglycemia (adjusted odds ratio 2.96, 95% confidence interval 1.29-6.82).

CONCLUSION

Neonates born to mothers with diabetes who received late preterm corticosteroids experienced greater odds of hypoglycemia.

摘要

目的

探讨对患有糖尿病的孕妇使用产前晚期早产儿皮质类固醇是否会增加新生儿低血糖的风险。

研究设计

这是一项回顾性队列研究,研究对象为在产前晚期早产儿皮质类固醇方案引入前后,34 0/7-36 6/7 周妊娠期间患有孕前或妊娠期糖尿病的个体。主要结局是出生后 24 小时内任何新生儿血糖≤60mg/dL。

结果

在 123 对母婴中,52.8%(N=65)在方案后期间分娩;其中 75.4%(N=49)接受了晚期早产儿皮质类固醇治疗。59.7%(N=34)的前方案新生儿和 81.5%(N=53)的后方案新生儿出现低血糖(p=0.008)。在控制分娩时的胎龄和分娩方式后,后方案组新生儿低血糖的发生几率增加(调整后的优势比 2.96,95%置信区间 1.29-6.82)。

结论

接受产前晚期皮质类固醇治疗的糖尿病孕妇所生新生儿低血糖的发生几率更高。

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Antenatal corticosteroids in the late preterm period for growth-restricted pregnancies.晚期早产儿生长受限的产前皮质激素治疗。
Am J Obstet Gynecol MFM. 2020 Aug;2(3):100153. doi: 10.1016/j.ajogmf.2020.100153. Epub 2020 Jun 13.

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