新生儿低血糖的临床表现及产科相关因素分析

Analysis on clinical manifestations and obstetrical related factors of neonatal hypoglycemia

目的探讨新生儿低血糖的临床表现,并对其相关危险因素进行分析。方法抽取该院2016年6月至2019年9月分娩的430例新生儿。将低血糖的新生儿纳入低血糖组,血糖正常的新生儿作为对照组,收集所有新生儿临床资料,分析新生儿低血糖的临床特征,并对相关危险因素采用单因素及多因素分析。结果新生儿低血糖中无症状性低血糖共28例(56.0%),有症状性低血糖22例(44.0%)。临床表现为反应差18例(36.0%),少哭少动14例(28.0%),嗜睡13例(26.0%),喂养困难9例(18.0%),吸吮无力7例(14.0%),低体温5例(10.0%),震颤4例(8.0%),尖叫2例(4.0%),发绀2例(4.0%),抽搐2例(4.0%),苍白1例(2.0%)。logistic多因素回归分析显示,妊娠期糖尿病(OR=12.818,95%CI:3.482~47.181)、妊娠期高血压(OR=4.256,95%CI:1.628~11.123)、宫内生长受限(OR=2.318,95%CI:1.071~5.013)、早产(OR=17.524,95%CI:8.931~34.385)和出生体重(OR=16.973,95%CI:8.664~33.249)是新生儿发生低血糖的主要危险因素。结论影响新生儿低血糖的因素较多,应加强高危新生儿血糖监测以降低其发生风险。

Objective To explore the clinical manifestations of neonatal hypoglycemia and to analyze its related risk factors.Methods A total of 430 neonates delivered in this hospital from June 2016 to March 2019 were extracted.The neonates with hypoglycemia were included into the hypoglycemia group,the neonates with normal blood glucose served as the control group.The clinical data of all neonates were collected and the clinical features of neonatal hypoglycemia were analyzed.The related risk factors conducted the univariate and multivariate analysis.Results Among the neonates with hypoglycemia,28 cases(56.0%)were unsymptomatic hypoglycemia,22 cases(44.0%)were symptomatic hypoglycemia.The clinical manifestations showed the poor response in 18 cases(36.0%),less crying and less moving in 14 cases(28.0%),drowsiness in 13 cases(26.0%),difficulty feeding in 9 cases(18.0%),sucking weakness in 7 cases(14.0%),hypothermia in 5 cases(10.0%),tremor in 4 cases(8.0%),screaming in 2 cases(4.0%),cyanosis in 2 cases(4.0%),convulsion in 2 cases(4.0%)and paleness in 1 case(2.0%).The Logistic multivariate regression analysis showed that gestational hypertension(OR=4.256,95%CI:1.628-11.123),gestational diabetes mellitus(OR=12.818,95%CI:3.482-47.181),intrauterine growth restriction(OR=2.318,95%CI:1.071-5.013),premature delivery(OR=17.524,95%CI:8.931-34.385)and birth weight(OR=16.973,95%CI:8.664-33.249)were the main risk factors for neonatal hypoglycemia occurrence.Conclusion There are many factors affecting neonatal hypoglycemia.It is neccessasy to strengthen the monitoring of neonatal blood glucose in order to decrease its occurrence risk.