摘要
目的:探讨妊娠期糖尿病子代发生低血糖的影响因素。方法:采用病例对照研究设计,收集2018年1月1日-2019年6月1日南方医科大学附属深圳妇幼保健院新生儿科收治的出生胎龄>34周诊断新生儿低血糖且其母亲患有妊娠期糖尿病的患儿共128例为病例组,同期住院的未诊断新生儿低血糖但母亲患有妊娠期糖尿病的新生儿128例为对照组。收集纳入病例与母亲的临床资料、生后24 h内血小板参数。采用秩和检验、χ~2检验和logistic回归分析各种因素对妊娠期糖尿病子代发生低血糖的影响意义。结果:单因素分析显示,两组双胎妊娠、初产妇、顺产、孕期血糖控制不佳以及妊娠期高血压疾病比例、出生胎龄、出生体重、入院时血气分析pH值、血小板计数、平均血小板体积比较,差异均有统计学意义(P<0.05)。多因素回归分析结果显示,双胎妊娠[OR=5.225,95%CI(1.070,25.527)]、孕期血糖控制不佳[OR=11.751,95%CI(3.775,36.579)]、妊娠期高血压疾病[OR=8.707,95%CI(1.875,40.439)]、平均血小板体积增高[OR=1.519,95%CI(1.020,2.257)]均是妊娠期糖尿病子代发生低血糖的危险因素,而顺产[OR=0.480,95%CI(0.242,0.953)是其保护因素。结论:双胎妊娠、孕期血糖控制不佳、妊娠期高血压疾病、平均血小板体积增高均是妊娠期糖尿病子代发生低血糖的危险因素,而顺产是其保护因素。
Objective:To explore the influencing factors of hypoglycemia in gestational diabetes mellitus offspring.Method:This was a retrospective case-control study.128 newborns(gestational age>34 weeks)diagnosed hypoglycemia born to gestational diabetes mellitus mothers were selected as case group,and 128 newborns(gestational age>34 weeks)without hypoglycemia born to gestational diabetes mellitus mothers were selected during the same period as the control group.All the newborns were hospitalized in the Neonatology Department of Shenzhen Maternity and Child Healthcare Hospital from January 1,2018 to June 1,2019.The clinical data and the plateletrelated parameters within 24 h of admission of the included cases were collected.Mann-Whitney U test,Chisquare and multivariate logistic regression were used to analyze the influencing factors of hypoglycemia in newborns born to gestational diabetes mellitus mothers.Result:Univariate analysis showed:the differences of proportion of twin pregnancy,primipara,and vaginal delivery,poor glycemic control and hypertension during pregnancy of two groups were statistically significant(P<0.05).In addition,the differences of gestational age,birth weight,pH value in blood gas analysis,platelet count and mean platelet volume of two groups were statistically significant(P<0.05).Multivariate regression analysis showed twin pregnancy[OR=5.225,95%CI(1.070,25.527)],poor glycemic control during pregnancy[OR=11.751,95%CI(3.775,36.579)],hypertension during pregnancy[OR=8.707,95%CI(1.875,40.439)and high mean platelet volume(MPV)[OR=1.519,95%CI(1.020,2.257)]were independent risks factor for hypoglycemia.Whereas vaginal delivery[OR=0.480,95%CI(0.242,0.953)]was a protective factor for hypoglycemia.Conclusion:Twin pregnancy,poor glycemic control during pregnancy,hypertensive disorder complicating pregnancy,high mean platelet volume are independent risk factors for gestational diabetes mellitus offspring,and vaginal delivery is an protective factor.
作者
钟俊炎
ZHONG Junyan(Affiliated Shenzhen Maternity&Child Healthcare Hospital,Southern Medical University,Shenzhen 518028,China)
出处
《中国医学创新》
CAS
2020年第24期48-52,共5页
Medical Innovation of China
基金
深圳市“医疗卫生三名工程”项目(SZSM201612045)
深圳市医学重点学科建设经费资助项目(深卫计科教[2018]61号)。
关键词
妊娠期糖尿病
子代
低血糖
影响因素
Gestational diabetes mellitus
Offspring
Hypoglycemia
Influencing factors
