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学术性三级护理中心中患有糖尿病母亲的新生儿低血糖及相关合并症

Hypoglycemia and associated comorbidities among newborns of mothers with diabetes in an academic tertiary care center.

作者信息

Bamehrez Maha

机构信息

Pediatric Department, King Abdul Aziz University Hospital, Jeddah, Saudi Arabia.

出版信息

Front Pediatr. 2023 Oct 13;11:1267248. doi: 10.3389/fped.2023.1267248. eCollection 2023.

Abstract

BACKGROUND

Hypoglycemia is considered the common metabolic problem in newborns with serious long-term sequelae. This study evaluates the incidence of hypoglycemia in the newborns of mothers with diabetes mellitus and assesses the comorbidities that affect the newborns of mothers with gestational diabetes compared with the newborns of mothers with pregestational diabetes mellitus.

METHODS

This retrospective cohort study was conducted between January-2018 and December-2020. All admissions to the hospital nursery of the newborns of diabetic mothers with diabetes mellitus were included.

RESULTS

The study comprised 1,036 mothers with diabetes, of the newborns of mothers with pregestational diabetes, 22% had hypoglycemia, and of mothers with gestational diabetes, 12%. Mothers with pregestational diabetes had a significantly higher risk of needing an emergency cesarean section (OR: 2.1, 95% CI: 1.3-3.4); and of having a baby who is large for its gestational age (OR: 9.5, 95% CI: 2.6-35.5), must be admitted to the NICU (OR: 2.9, 95% CI: 1.5-5.6), has respiratory distress syndrome (OR: 3.3, 95% CI: 1.5-7.4), and needs gavage feeding (OR: 3.5, 95% CI: 1.4-8.9).

CONCLUSION

About 13% of the newborns of mothers with diabetes had hypoglycemia. Significantly more of these newborns were of mothers with pregestational diabetes than of mothers with gestational diabetes. Newborn of mothers with pregestational diabetes mellitus have the risk of large weight and neurological problems, such as sucking difficulties, length of hospital stay, NICU admission, and respiratory distress syndrome.

摘要

背景

低血糖被认为是新生儿常见的代谢问题,会导致严重的长期后遗症。本研究评估糖尿病母亲所生新生儿的低血糖发生率,并评估与孕前糖尿病母亲所生新生儿相比,影响妊娠期糖尿病母亲所生新生儿的合并症。

方法

本回顾性队列研究于2018年1月至2020年12月进行。纳入所有糖尿病母亲所生新生儿入住医院新生儿病房的病例。

结果

该研究包括1036名糖尿病母亲,孕前糖尿病母亲所生新生儿中,22%发生低血糖,妊娠期糖尿病母亲所生新生儿中,12%发生低血糖。孕前糖尿病母亲需要急诊剖宫产的风险显著更高(比值比:2.1,95%置信区间:1.3 - 3.4);所生孩子为大于胎龄儿的风险更高(比值比:9.5,95%置信区间:2.6 - 35.5),必须入住新生儿重症监护病房的风险更高(比值比:2.9,95%置信区间:1.5 - 5.6),发生呼吸窘迫综合征的风险更高(比值比:3.3,95%置信区间:1.5 - 7.4),需要管饲喂养的风险更高(比值比:3.5,95%置信区间:1.4 - 8.9)。

结论

糖尿病母亲所生新生儿中约13%发生低血糖。这些新生儿中,孕前糖尿病母亲所生的明显多于妊娠期糖尿病母亲所生的。孕前糖尿病母亲所生新生儿有体重过大和神经问题的风险,如吸吮困难、住院时间、入住新生儿重症监护病房以及呼吸窘迫综合征。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a987/10611491/6539d68174a9/fped-11-1267248-g001.jpg

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