Division of Perinatal Medicine, Policlinic Abano, Abano Terme, Italy.
Ferrara University, Ferrara, Italy.
Diabetes Res Clin Pract. 2023 Jun;200:110643. doi: 10.1016/j.diabres.2023.110643. Epub 2023 Mar 26.
To investigate the trajectory of bilirubin from birth to the first 48 h of life in neonates of women with gestational diabetes.
In a cohort of 69 neonates of women with gestational diabetes, delivered at Policlinic Abano, Abano Terme, Italy, from October 2021 to May 2022, we conducted a case-control study (1:2 ratio) on total serum bilirubin (TSB) trajectory over the first 48 h after birth. An ancillary analysis was conducted on arterial cord blood gas analysis at birth and on concurrent hemoglobin, hematocrit, lactate, glycemia, and bilirubin levels.
The neonates of women with gestational diabetes showed a significantly higher mean percent variation of TSB from birth to the first 48 h of life (p = 0.01), a finding supported by a higher, although not significant, TSB levels at 48 h of life in comparison to controls (8.05 ± 4.8 vs 8.05 ± 4 mg%, p = 0.082), and by a significantly lower cord TSB levels (2.3 ± 0.9 vs 2.6 ± 0.9 mg%, p = 0.010).
The findings suggest that future primary studies on hyperbilirubinemia risk in neonates of women with gestational diabetes should consider the trajectory of TSB beyond the first 48 h, adjusting for a more complete set of pre-pregnancy and gestational prognostic risk factors.
研究患有妊娠糖尿病女性新生儿在出生后 48 小时内胆红素的变化轨迹。
在意大利阿巴诺普里科利尼克妇产科医院，于 2021 年 10 月至 2022 年 5 月期间，对 69 例患有妊娠糖尿病的新生儿进行了一项病例对照研究（1:2 比例），研究了出生后前 48 小时内总血清胆红素（TSB）的变化轨迹。对出生时动脉脐带血气分析以及同时的血红蛋白、红细胞压积、乳酸、血糖和胆红素水平进行了辅助分析。
患有妊娠糖尿病的新生儿从出生到出生后 48 小时的 TSB 平均变化百分比明显更高（p=0.01），这一发现得到了支持，即与对照组相比，48 小时的 TSB 水平虽然没有显著差异，但更高（8.05±4.8 与 8.05±4mg%，p=0.082），同时，脐带 TSB 水平明显更低（2.3±0.9 与 2.6±0.9mg%，p=0.010）。
这些发现表明，未来关于妊娠糖尿病女性新生儿高胆红素血症风险的研究应考虑 TSB 的变化轨迹超过 48 小时，并调整更完整的孕前和妊娠期预后风险因素。
