妊娠期糖尿病对新生儿心脏发育、免疫功能和脐血胆红素的影响

Effects of Gestational Diabetes Mellitus on Neonatal Cardiac Development,Immune Function,and Cord Blood Bilirubin

目的:探讨妊娠期糖尿病(GDM)对新生儿心脏发育、免疫功能和脐血胆红素的影响。方法:回顾性分析2019年7月至2021年7月在我院足月分娩的80例GDM患者的新生儿(GDM组)及40例健康产妇的新生儿(对照组)的临床资料。比较两组新生儿的一般指标、心脏发育指标、免疫功能指标及脐血胆红素水平的差异。结果:GDM组新生儿出生体质量高于对照组(P<0.05);两组身长、性别、胎龄比较无差异(P>0.05)。GDM组新生儿主动脉/主肺动脉宽度、左心房、左/右心室大小及室间隔厚度较对照组大(P<0.05);两组左室短轴短缩率、射血分数比较无差异(P>0.05)。GDM组新生儿的血清免疫球蛋白(Ig)G、CD3、CD4、CD4/CD8水平低于对照组,CD8水平高于对照组(P<0.05);两组的血清IgM和IgA水平相比,差异无统计学意义(P>0.05)。GDM组新生儿的脐血胆红素水平为(41.25±8.06)μmol/L,高于对照组新生儿的(33.36±7.52)μmol/L,差异有统计学意义(P<0.05)。结论:GDM对新生儿的心脏发育有不利影响,可导致心肌肥厚,GDM新生儿的免疫功能显著降低,GDM还可导致新生儿脐血胆红素水平升高。

Objective:To investigate the effects of gestational diabetes mellitus(GDM)on neonatal cardiac development,immune function and cord blood bilirubin.Methods:The clinical data of 80 neonates of GDM patients(GDM group)and 40 neonates(control group)of healthy parturients delivered in our hospital from July 2019 to July 2021 were retrospectively analyzed.The differences of general indexes,cardiac development indexes,immune function indexes and umbilical cord blood bilirubin levels between the two groups were compared.Result:The birth weight of neonatal in GDM group was higher than that in control group(P<0.05).There were no differences in body length,gender and gestational age between the two groups(P>0.05).The aorta/main pulmonary artery width,the size of left atrium,left/right ventricle and the ventricular septum thickness in GDM group neonatal were greater than those in control group(P<0.05).There were no differences in left ventricular short axis contraction rate and ejection fraction between the two groups(P>0.05).The serum immunoglobulin(Ig)G,CD3,CD4 and CD4/CD8 levels in GDM group neonatal were lower than those in control group,and the CD8 level was higher than that in control group(P<0.05).There were no significant differences in serum IgM and IgA levels between the two groups(P>0.05).The cord blood bilirubin level in GDM group neonatal was(41.25±8.06)μmol/L,which was higher than(33.36±7.52)μmol/L in the control group neonatal,the difference was statistically significant(P<0.05).Conclusion:GDM has adverse effects on neonatal heart development,which can lead to myocardial hypertrophy,significantly reduce the immune function of GDM neonatal,and increased neonatal cord blood bilirubin level.