早产儿无症状性低血糖：一项横断面分析。

Asymptomatic hypoglycemia among preterm newborns: A cross-sectional analysis.

机构信息

Dept of Paediatrics/Child Health, Hubert Kairuki Memorial University, Dar es Salaam, Tanzania.

Dept of Paediatrics/Child Health, Muhimbili National Hospital (Mloganzila), Dar es Salaam, Tanzania.

出版信息

PLoS One. 2024 Apr 30;19(4):e0301803. doi: 10.1371/journal.pone.0301803. eCollection 2024.

DOI:10.1371/journal.pone.0301803

PMID:38687725

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11060517/

Abstract

BACKGROUND

Hypoglycemia is the commonest metabolic abnormality encountered in newborns. Besides, there is a growing body of evidence that links the causes of early neonatal mortality to neonatal hypoglycemia in Tanzania. However exact factors associated with asymptomatic hypoglycemia in preterm newborns are not known.

OBJECTIVE

To assess factors associated with asymptomatic hypoglycemia among preterm newborns.

MATERIALS AND METHODS

A cross sectional, analytical hospital- based study was carried out at Dar es salaam public regional referral hospitals. Preterm newborns with asymptomatic hypoglycemia were the target population. Data on demographic and clinical characteristics of preterm newborns and their mothers were collected and analyzed using Epi-Info™ software version 7.4. Main data analysis was done by applying a multivariable binary logistic regression model with neonatal random glycaemia coded in a binary fashion at a cut-off point of 2.6 mmol/L. An α-level of 5% was used as a limit of type I error.

RESULTS

We recruited and analysed 217 preterm newborns within 6-24 hours post-delivery. Male: Female = 1.1:1 (females n = 105, 48.4%). Median glycemic level was 2.6 (IQR; 2.1-3.9) mmol/L. Median gestational age at delivery was 33 (IQR: 30-35) weeks. Breastfeeding within 1st hour post-delivery was a statistically significant factor against glycemic levels associated with hypoglycemia (OR; 0.123, 95%-CI; 0.052-0.287) in a fitted multivariable logistic regression model.

CONCLUSION

About half of all preterm newborns studied had glycemic values in a statistical range associated with hypoglycemia. Exclusive breast feeding within 1st hour post-delivery was associated with glycemic levels protective from risk of asymptomatic neonatal hypoglycemia.

RECOMMENDATIONS

Exclusive breastfeeding practices within 1st hour post-delivery may need to be emphasized to all expectant mothers in order to avoid potential risk of asymptomatic hypoglycemia in preterm newborns.

摘要

背景

低血糖是新生儿最常见的代谢异常。此外，越来越多的证据表明，坦桑尼亚新生儿早期死亡的原因与新生儿低血糖有关。然而，早产儿无症状低血糖的确切相关因素尚不清楚。

目的

评估早产儿无症状低血糖的相关因素。

材料和方法

这是一项在达累斯萨拉姆公立区域转诊医院进行的横断面、分析性医院研究。无症状低血糖的早产儿为目标人群。收集并分析早产儿及其母亲的人口统计学和临床特征数据，使用 Epi-Info™ 软件版本 7.4 进行分析。主要数据分析采用多变量二项逻辑回归模型，将新生儿随机血糖编码为二进制，截断值为 2.6mmol/L。采用 5%的α水平作为Ⅰ类错误的限值。

结果

我们在出生后 6-24 小时内招募并分析了 217 名早产儿。男：女=1.1:1（女性 n=105，48.4%）。中位血糖水平为 2.6（IQR；2.1-3.9）mmol/L。中位分娩时胎龄为 33（IQR：30-35）周。出生后 1 小时内进行母乳喂养是与低血糖相关的血糖水平的统计学显著因素（OR；0.123，95%-CI；0.052-0.287）在拟合的多变量逻辑回归模型中。