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分析新生儿低血糖的危险因素及其与妊娠期糖尿病患者血糖控制的相关性:一项回顾性研究。

Analysis of risk factors of neonatal hypoglycemia and its correlation with blood glucose control of gestational diabetes mellitus: A retrospective study.

机构信息

Department of Obstetrics Staff Nurse, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China.

Department of Staff Nurse of Children's Health, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China.

出版信息

Medicine (Baltimore). 2023 Sep 1;102(35):e34619. doi: 10.1097/MD.0000000000034619.

Abstract

This study aimed to investigate the risk factors associated with neonatal hypoglycemia and its correlation with blood glucose control in patients with gestational diabetes mellitus (GDM). This study was a retrospective study. 880 pregnant women with GDM and their newborns were hospitalized from January 2018 to December 2022 in our hospital. The clinical information of GDM pregnant women and their newborns were reviewed and the hemoglobin A1c (HbA1c) values measured within 1 week before delivery were collected. According to the occurrence of neonatal hypoglycemia, which was divided into the control and observation groups. Logistic regression model was used to estimate the potential factors associated with neonatal hypoglycemia. The association between HbA1c of pregnant women before delivery and abnormal glucose metabolism in newborns was examined using spearman correlation analysis. A total of 104 cases of hypoglycemia occurred in neonates delivered by 880 GDM women and the incidence of neonatal hypoglycemia was 11.82%. There were significant differences in pre-pregnancy overweight or obesity, delivery mode, maternal blood sugar control effect and neonatal feeding standard between the 2 groups of GDM women (P < .05). Pre-pregnancy overweight or obesity, poor blood sugar control in GDM women, and improper neonatal feeding were risk factors for neonatal hypoglycemia. The results of logistic regression analysis showed that abnormal glucose metabolism in newborn (odds ratio [OR]: 2.43, 95% confidence interval [CI]: 1.12-4.73) and neonatal hypoglycemia (OR: 3.04, 95% CI: 1.33-5.79) were a risk factor. We also conducted the logistic analysis to evaluate the correlation between HbA1c before delivery and abnormal glucose metabolism in newborns of pregnant women with GDM through adjusting some potential factors. The results were still significant in the abnormal glucose metabolism in newborn (OR: 2.84, 95% CI: 1.23-6.63) and neonatal hypoglycemia (OR: 3.64, 95% CI: 1.46-8.18). Overweight or obesity of GDM parturient before pregnancy, poor blood glucose control of GDM parturient and improper feeding of newborns are all risk factors for neonatal hypoglycemia. HbA1c before delivery has a certain predictive value for abnormal glucose metabolism in newborns.

摘要

本研究旨在探讨与妊娠期糖尿病(GDM)患者新生儿低血糖相关的风险因素及其与血糖控制的相关性。本研究为回顾性研究。选取 2018 年 1 月至 2022 年 12 月在我院住院的 880 例 GDM 孕妇及其新生儿,回顾性分析 GDM 孕妇及其新生儿的临床资料,并收集孕妇分娩前 1 周内的糖化血红蛋白(HbA1c)值。根据新生儿是否发生低血糖,分为对照组和观察组。采用 logistic 回归模型估计与新生儿低血糖相关的潜在因素。采用 Spearman 相关分析检验孕妇分娩前 HbA1c 值与新生儿糖代谢异常的相关性。880 例 GDM 孕妇中,104 例新生儿发生低血糖,新生儿低血糖发生率为 11.82%。两组 GDM 孕妇在孕前超重或肥胖、分娩方式、母血糖控制效果及新生儿喂养标准方面比较,差异有统计学意义(P<0.05)。孕前超重或肥胖、GDM 孕妇血糖控制不佳、新生儿喂养不当是新生儿低血糖的危险因素。logistic 回归分析结果显示,新生儿糖代谢异常(比值比[OR]:2.43,95%置信区间[CI]:1.124.73)和新生儿低血糖(OR:3.04,95%CI:1.335.79)是危险因素。我们还通过调整一些潜在因素,对 GDM 孕妇分娩前 HbA1c 值与新生儿糖代谢异常进行 logistic 分析,结果显示新生儿糖代谢异常(OR:2.84,95%CI:1.236.63)和新生儿低血糖(OR:3.64,95%CI:1.468.18)仍有统计学意义。GDM 产妇孕前超重或肥胖、GDM 产妇血糖控制不佳、新生儿喂养不当均为新生儿低血糖的危险因素。分娩前 HbA1c 值对新生儿糖代谢异常有一定的预测价值。

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