摘要
目的探讨糖尿病母亲婴儿(IDMS)出生后血糖的变化情况,分析IDMS发生低血糖的可能影响因素。方法回顾性横断面调查,纳入2014年1月1日至12月31日在福建省妇幼保健院(我院)定期产检和分娩、单胎活产的全部妊娠期糖尿病(GDM)产妇,收集产妇和新生儿的一般临床资料、母亲孕产期血糖值和IDMS出生后48 h内各时点的血糖值。血糖值<2.2、~2.6 mmol·L^(-1)为低血糖和临界低血糖。多因素Logistic回归分析IDMS低血糖、临界低血糖的影响因素。结果共1 083份病志进入本文分析。(1)GDM产妇年龄(30.2±4.2)岁,(39.1±1.4)孕周,初产妇66.8%,阴道分娩82.4%,孕前BMI<18.5者4.5%、≥25者9.8%。1 083例IDMS中,早产儿3.8%,男52.5%,Apgar评分均≥8分,出生体重(3 303.7±428.2)g。(2)IDMS出生0.5 h时平均血糖明显下降,2~48 h呈上升趋势。母亲孕前BMI 18.5~24.9、阴道分娩、足月儿、总产程时间≥7 h、傍晚至夜间分娩、正常体重儿的IDMS出生时和生后某些时点的平均末梢血糖相对较高。(3)1 083例IDMS中,低血糖7例(0.65%),6例发生在出生时,1例发生在生后48 h;临界低血糖29例(2.68%),26例发生在出生时,生后12、24和48 h各1例。(4)多因素非条件Logistic回归显示,孕末期静脉血糖水平高是新生儿低血糖、临界低血糖的保护因素。结论 IDMS生后48 h内发生低血糖的时间以出生时最多,但生后48 h都有发生低血糖的可能,应密切监测。GDM孕妇孕末期静脉血糖水平高可能是新生儿低血糖和临界低血糖的保护因素。
Objective To investigate the changes of blood glucose after birth in infants of diabetic mothers （IDMS）, and toanalyze the possible influencing factors of hypoglycemia in IDMS, in order to standardize the IDMS monitoring pathway and reducethe incidence of hypoglycemia. Methods A retrospective cross-sectional study was conducted to examine all GDM parturients whounderwent regular birth examination and delivery during the period from January 1st, 2014 to December 31st, 2014 in FujianProvincial Maternity and Child Care Center （ our hospital）, maternal and neonatal general clinical data, maternal blood glucosevalues and blood glucose values at each time point within 48 h after birth were collected in IDMS. The blood sugar value 〈2.2 mmol·L-1was considered as neonatal hypoglycemia, and ～ 2.6 mmol·L-1critical hypoglycemia. The influencing factors of lowblood glucose and critical hypoglycemia of IDMS were analyzed by multifactor non-conditional logistic regression. Results A totalof 1,083 patients were analyzed in this study. ①Among the 1,083 cases of GDM, the maternal age was（30.2 ± 4.2）, gestationalweek （39.1±1.4）, 66.8% of the first parturition, 82.4% of the vaginal delivery, and the pre？pregnancy BMI〈 18.5, 4.5%, or 25,9.8%.Among the 1,083 cases of IDMS, 3.8% of premature infants, 52.5% of men, and Apgar scores were all equal to 8 points andbirth weight （3 303.7 ± 428.2） g. ②When IDMS were born 0.5 h, average blood glucose decreased significantly, and 2 h rose to48 h. Maternal pre？pregnancy BMI18.5～ 24.9, vaginal delivery, full moon, total delivery time of 7 h, evening to night delivery,normal weight of IDMS, and the average peripheral blood glucose at some points of time after birth were relatively high. ③Of the1 083 cases of IDMS, 7 were hypoglycemic （ 0. 65%）, 6 occurred at birth, and 1 occurred at 48 h after birth. The criticalhypoglycemia was 29 cases （ 2. 68%）, and the 26 cases occurred at the birth and one case each 12, 24 and 48 h after birthrespectively. �
出处
《中国循证儿科杂志》
CSCD
北大核心
2017年第5期342-346,共5页
Chinese Journal of Evidence Based Pediatrics
基金
福建省妇幼保健院资助项目:妇保院研17-05
关键词
糖尿病母亲新生儿
48h
血糖
趋势
影响因素
Infants of diabetic mothers
48 h
Blood sugar
Trend
Influencing factors
