早产儿早期低血糖的发生率及危险因素研究

Study on the incidence and risk factors of early hypoglycemia in neonates born preterm

目的探讨早产儿早期低血糖的发生率及危险因素。方法前瞻性连续纳入2017年4月至2019年8月在崇左市复退军人医院分娩的小于37孕周的新生儿。新生儿在出生30min内未开奶前足跟采血,采用微量血糖检测仪行快速血糖检测。计算新生儿低血糖(血糖水平<2.2mmol/L)的发生率。单因素分析比较发生低血糖和未发生低血糖的新生儿组间母婴一般情况、干预方式、临床结局之间的差异,P<0.1的变量纳入多因素Logistic回归模型考察早产儿发生低血糖的独立危险因素。结果共纳入175例孕周小于37周的新生儿,低血糖发生率为33.7%(n=59)。母亲高血压(是vs否:OR=2.40,95%CI=1.03-5.71)和糖尿病(是vs否:OR=1.87,95%CI=1.25-2.62)是早产新生儿发生低血糖的独立危险因素。而阴道分娩(否vs是:OR=3.63,95%CI=1.61-8.41)和产妇使用MgSO4(否vs是:OR=2.53,95%CI=1.23-5.50)是早产新生儿发生低血糖的保护因素。结论早产儿早期低血糖发生率为33.7%。孕妇高血压和糖尿病会增加新生儿低血糖的风险。产前给予硫酸镁和阴道分娩可降低新生儿低血糖的风险。

Objective To investigate the incidence and risk factors of early hypoglycemia in preterm infants.Methods Newborns<37weeks of gestational age who were delivered at Chongzuo military hospital from April 2017to August 2019were prospectively included.The blood samples were collected from the heel of the newborn within 30minutes before the milk was opened,and 0.03-0.05ml blood was collected.The incidence of neonatal hypoglycemia(blood glucose level<2.2mmol/L)was calculated.Unifactorial analysis was performed to compare the differences in maternal and infant general conditions,intervention methods and clinical outcomes between groups of newborns with and without hypoglycemia.Variables P<0.1were included in the multivariate Logistic regression model to investigate the independent risk factors for hypoglycemia in premature infants.Results A total of 175newborns with gestational age less than 37w were included,and the incidence of hypoglycemia was 33.7%(n=59).Maternal hypertension(yes vs.no:OR=2.40,95%CI=1.03-5.71)diabetes(yes vs.no:OR=1.87,95%CI=1.25-2.62)is an independent risk factor for hypoglycemia in premature newborns.Vaginal delivery(no vs yes:OR=3.63,95%CI=1.61-8.41)and maternal use of Mg-SO4(no vs yes:OR=2.53,95%CI=1.23-5.50)were protective factors for hypoglycemia in premature newborns.Conclusion The incidence of early hypoglycemia in preterm infants was 33.7%.High blood pressure and diabetes in pregnant women increase the risk of hypoglycemia in newborns.Prenatal administration of magnesium sulfate and vaginal delivery may reduce the risk of hypoglycemia in newborns.