中国循证儿科杂志2017，Vol.12Issue(5)：342-346,5.DOI:10.3969/j.issn.1673-5501.2017.05.005
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
Dynamic changes of blood glucose in newborns with gestational diabetes mellitus within 48 hours after birth and the influencing factors of hypoglycemia
摘要
Abstract
Objective To investigate the changes of blood glucose after birth in infants of diabetic mothers (IDMS),and to analyze the possible influencing factors of hypoglycemia in IDMS,in order to standardize the IDMS monitoring pathway and reduce the incidence of hypoglycemia.Methods A retrospective cross-sectional study was conducted to examine all GDM parturients who underwent regular birth examination and delivery during the period from January 1st,2014 to December 31st,2014 in Fujian Provincial Maternity and Child Care Center (our hospital),maternal and neonatal general clinical data,maternal blood glucose values 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-1 was considered as neonatal hypoglycemia,and ～2.6 mmol · L-1 critical hypoglycemia.The influencing factors of low blood glucose and critical hypoglycemia of IDMS were analyzed by multifactor non-conditional logistic regression.Results A total of 1,083 patients were analyzed in this study.①Among the 1,083 cases of GDM,the maternal age was(30.2 ± 4.2),gestational week (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 and birth weight (3 303.7 + 428.2) g.②When IDMS were born 0.5 h,average blood glucose decreased significantly,and 2 h rose to 48 h.Maternal pre-pregnancy BMI1S.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 the 1 083 cases of IDMS,7 were hypoglycemic (0.65％),6 occurred at birth,and 1 occurred at 48 h after birth.The critical hypoglycemia was 29 cases (2.68％),and the 26 cases occurred at the birth and one case each 12,24 and 48 h after birth respectively.④Multifactor non-conditional logistic regression showed that high blood glucose level was the protective factor for hypoglycemia and critical hypoglycemia in neonates.Conclusion The time of hypoglycemia occurred at 48 h after the birth of IDMS,but it could occur any time within 48 h and should be closely monitored.The high blood glucose level of GDM in the end of pregnancy may be a protective factor for hypoglycemia and hypoglycemia in newborns.关键词
糖尿病母亲新生儿/48 h/血糖/趋势/影响因素Key words
Infants of diabetic mothers/48 h/Blood sugar/Trend/Influencing factors引用本文复制引用
黄欣欣,江秀敏,林艳,周衔玲..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[J].中国循证儿科杂志,2017,12(5):342-346,5.基金项目
福建省妇幼保健院资助项目:妇保院研17-05 （）
