临床误诊误治2025，Vol.38Issue(2)：41-46,6.DOI:10.3969/j.issn.1002-3429.2025.02.009
妊娠期糖尿病患者分娩前糖化血红蛋白控制水平对大于胎龄儿、新生儿低血糖发生风险的影响
Effect of Control Level of Glycated Hemoglobin in the Third Trimester of Gestational Diabetes Mellitus on the Risk of Hypoglycemia in Infants Lar-ger than Gestational Age and Neonates
摘要
Abstract
Objective To investigate the effect of control level of glycated hemoglobin A1c(HbA1c)before delivery on the risk of hypoglycemia in infants larger than gestational age(LGA)and neonates in patients with gestational diabetes mel-litus(GDM).Methods The clinical data of 172 GDM patients and their neonates from April 2020 to May 2023 were retro-spectively analyzed.According to the HbA1c value of GDM patients at 1 week before delivery,172 patients were divided into group A(n=60,HbA1c＜6.0%),group B(n=81,HbA1c 6.0%～7.0%),and group C(n=31,HbA1c≥7.0%).Baseline data of GDM patients and neonates in the three groups were collected to compare the occurrence of LGA and neonatal hypoglycemia in the three groups,and the relationship between different HbA1c control levels and LGA and neonatal hypogly-cemia in GDM patients in the third trimester was analyzed by multivariate logistic regression model.Results Fasting blood glucose,newborn birth weight and 1-min Apgar score of the three groups were the lowest in group A,followed by group B and group C(P＜0.05).The initial blood glucose values of the three groups were the highest in group A,followed by group B and group C(P＜0.05).The incidence of LGA and neonatal hypoglycemia in the three groups was the lowest in group A,followed by group B and group C(P＜0.05).Multivariate logistic regression analysis showed that HbA1c levels of 6.0%-7.0%and≥7.0%before delivery were independent risk factors for LGA and neonatal hypoglycemia in GDM patients(P＜0.01).Compared with GDM patients with HbA1c＜6.0%,the risk of LGA was increased by 1.644 and 2.124 times,respectively,and the risk of neonatal hypoglycemia was increased by 1.650 and 2.045 times,respectively.Conclusion HbA1c level of GDM patients in the third trimester of pregnancy is closely related to newborn body mass and blood glucose.Active and effec-tive intervention of HbA1c level of GDM patients before delivery can effectively reduce the risk of LGA and neonatal hypogly-cemia.关键词
妊娠期糖尿病/孕晚期/糖化血红蛋白/大于胎龄儿/新生儿低血糖/影响因素分析Key words
Gestational diabetes mellitus/Late pregnancy/Glycated hemoglobin/Larger than gestational age/Neo-natal hypoglycemia/Analysis of influencing factors分类
医药卫生引用本文复制引用
乔艳华,李晓敏,白章莹,崔艳杰,孔玉玲..妊娠期糖尿病患者分娩前糖化血红蛋白控制水平对大于胎龄儿、新生儿低血糖发生风险的影响[J].临床误诊误治,2025,38(2):41-46,6.基金项目
河北省2020年度医学科学研究课题计划(20200444) （20200444）
