妊娠期糖尿病母亲的新生儿出生48小时内血糖的动态变化及低血糖的影响因素

发布时间：2018-04-21 20:53

  本文选题：糖尿病母亲新生儿 + h　； 参考：《中国循证儿科杂志》2017年05期

【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BMI18.5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。
[Abstract]:Objective to investigate the changes of postnatal blood glucose in infants with diabetes mellitus (DM) and analyze the possible influencing factors of hypoglycemia in IDMS. Methods from January 1 to December 31, 2014, a retrospective cross-sectional survey was conducted on all pregnant women with diabetes mellitus (GDM) in Fujian Provincial Maternal and Child Health Hospital (our hospital). The general clinical data of puerpera and newborns, maternal blood glucose during pregnancy and delivery and the blood glucose values of each time point within 48 hours after IDMS were collected. The blood glucose value was 2.2 mmol / L ~ (-1) and hypoglycemia and borderline hypoglycemia were observed. Multivariate Logistic regression analysis was used to analyze the influencing factors of IDMS hypoglycemia and critical hypoglycemia. Results A total of 1 083 diseased records were included in the analysis. The age of pregnant women was 30.2 卤4.2 years old and 39.1 卤1.4) gestational weeks. The puerpera was 66.8, vaginal delivery was 82.4, prepregnancy BMI18.5 was 4.5, and 鈮，

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