摘要
目的探讨母亲妊娠期糖尿病(GDM)对早期新生儿呼吸系统疾病的影响。方法以2018年1月-12月钦州市妇幼保健院产科分娩的单胎、活产新生儿5702例为研究对象,根据母亲是否患GDM将新生儿分为GDM组(n=830)和非GDM组(n=4872);再根据其母孕期血糖是否在控制目标值内,将GDM组分为血糖控制达标组(n=755)和血糖控制不达标组(n=75)。比较各组新生儿呼吸窘迫综合征(RDS)、新生儿湿肺、感染性肺炎、气胸、胎粪吸入综合征的发生率和机械通气需求情况。结果GDM组早产(10.60%vs.7.02%)、巨大儿(5.42%vs.2.36%)、剖宫产(42.41%vs.34.56%)发生率高于非GDM组,差异有统计学意义(P<0.05);GDM组湿肺发生率高于非GDM组(1.20%vs.0.39%,P<0.05)。母亲孕期血糖控制不达标组呼吸系统疾病(17.33%vs.2.91%)、新RDS(5.33%vs.1.32%)、湿肺(8.00%vs.0.53%)发生率高于血糖控制达标组,需要呼吸支持的比例高于血糖控制达标组(8.0%vs.1.2%),差异有统计学意义(P<0.05);GDM母亲血糖控制不达标是呼吸系统疾病(OR=6.986,95%CI:3.357~14.540,P=0.000)、新生儿湿肺(OR=3.593,95%CI:1.990~6.488,P=0.000)的危险因素。结论孕期血糖控制不良的GDM母亲分娩的新生儿呼吸系统疾病、RDS、湿肺的发生率和需呼吸支持比例增高,GDM母亲血糖控制不达标是呼吸系统系统疾病、新生儿湿肺的危险因素,应重视GDM母亲围产保健,使其孕期的血糖得到良好控制以改善新生儿的临床预后。
Objective To investigate the effect of maternal gestational diabetes mellitus(GDM)on early neonatal respiratory diseases.Methods A total of 5702 singleton and live birth newborns delivered in the Department of Obstetrics,Qinzhou Maternal and Child Health Care Hospital from January to December 2018 were selected as the research objects.According to whether the mother had GDM,the newborns were divided into GDM group(n=830)and non-GDM group(n=4872).According to whether the maternal blood glucose during pregnancy was within the control target value,the GDM group was divided into the blood glucose control target group(n=755)and the blood glucose control non-target group(n=75).The incidence of neonatal respiratory distress syndrome(RDS),neonatal wet lung,infectious pneumonia,pneumothorax,meconium aspiration syndrome and mechanical ventilation requirements were compared among the groups.Results The incidences of premature delivery(10.60%vs.7.02%),macrosomia(5.42%vs.2.36%)and cesarean section(42.41%vs.34.56%)in GDM group were higher than that in non-GDM group,and the difference were statistically significant(P<0.05).The incidence of wet lung in GDM group was higher than that in non-GDM group(1.20%vs.0.39%),P<0.05.The incidences of respiratory diseases(17.33%vs.2.91%),RDS(5.33%vs.1.32%),wet lung(8.00%vs.0.53%)and the need for respiratory support(8.0%vs.1.2%)in the blood glucose control target group were higher than those in the blood glucose control non-target group,and the differences were statistically significant(P<0.05).The substandard blood glucose control of GDM mothers was a risk factor for respiratory diseases(OR=6.986,95%CI:3.357-14.540,P=0.000)and neonatal wet lung(OR=3.593,95%CI:1.990-6.488,P=0.000).Conclusion The incidence of neonatal respiratory diseases,RDS,wet lung and the proportion of respiratory support are increased in GDM mothers with poor blood glucose control during pregnancy.The substandard blood glucose control of GDM mothers is a risk factor for respiratory diseases and neonatal wet lung.We should
作者
陆岸锋
黄海燕
黄萍
黄培禄
毕雷
黄国盛
LU An-feng;Huang Hai-yan;HUANG Ping;HUANG Pei-lu;BI Lei;HUANG Guo-sheng(Department of Neonatology,Department of Obstetrics,Qinzhou 535099,Guangxi,China;Department of Neonatology,Qinzhou Meternal and Child Health Care Hospital,Qinzhou 535099,Guangxi,China)
出处
《医学信息》
2024年第18期70-74,共5页
Journal of Medical Information
基金
钦州市科学研究与技术开发计划项目(编号:201811504)。
关键词
妊娠期糖尿病
呼吸系统疾病
新生儿
血糖
湿肺
Gestational diabetes mellitus
Respiratory diseases
Neonate
Blood glucose
Wet lung
