妊娠糖尿病患者孕晚期血清脂肪因子水平对新生儿低血糖及相关并发症的影响

Effect of serum adipose factor level in late pregnancy on neonatal hypoglycemia and related complications in patients with gestational diabetes mellitus

目的 探究妊娠糖尿病患者孕晚期血清脂肪因子水平对新生儿低血糖及相关并发症的影响。方法 回顾性分析2019年3月至2022年3月自贡市妇幼保健院收治的144例产妇的临床资料,采用随机数字法将就诊患者以2∶1的比例分为训练集(96例)和验证集(48例)。训练集患者根据新生儿血糖,分为新生儿低血糖组(67例)和非新生儿低血糖组(29例)。对比两组临床资料,采用平滑曲线拟合分析血清脂肪因子水平与新生儿低血糖的曲线关系;采用受试者工作特征曲线(ROC)分析血清脂肪因子水平对新生儿低血糖的预测价值;采用多因素Logistic回归分析探讨新生儿低血糖的影响因素;构建人工神经网络模型并评价其预测效能。比较不同血清脂肪因子水平对新生儿及孕妇相关并发症发生情况的影响。结果 训练集患者新生儿低血糖发生率为68.38%,血清脂肪因子水平与新生儿低血糖的发生呈线性正相关关系,血清脂肪因子水平对新生儿低血糖具有一定的预测价值(AUC=0.733)。多因素分析结果显示,早产、宫内感染、低出生体质量、新生儿窒息、新生儿腹泻、血清脂肪因子水平,均为影响新生儿低血糖发生的独立危险因素(P<0.05);构建的预测模型具有良好的预测效能。血清脂肪因子水平异常组相关并发症发生率显著高于血清脂肪因子水平正常组,差异具有统计学意义(P<0.05)。结论 妊娠糖尿病患者孕晚期血清脂肪因子水平对新生儿低血糖及相关并发症具有显著影响,血清脂肪因子水平对新生儿低血糖具有一定的预测价值。

Objective To explore the effect of serum adipose factor levels in the late pregnancy of patients with gestational diabetes on neonatal hypoglycemia and related complications.Methods Retrospective analysis of the clinical data of 144 pregnant women admitted to Zigong Hospital Of Woman and Children Healthcare from March 2019 to March 2022.The patients were randomly divided into training set(96 cases)and verification set(48 cases)at a ratio of 2∶1.Patients in the training set were divided into neonatal hypoglycemia group(67 cases)and non neonatal hypoglycemia group(29 cases)according to neonatal blood glucose.Comparison of clinical data between the two groups.Analysis the relationship between the serum adipose factor levels and neonatal hypoglycemia by smooth curve fitting.Analysis the predictive value of serum adipose factor level on neonatal hypoglycemia by receiver operating characteristic curve(ROC).Study on the influencing factors of neonatal hypoglycemia by multifactor Logistic regression analysis.Building the artificial neural network model and evaluate the prediction efficiency.To compare the influence of different levels of serum adipose factor on the incidence of related complications in neonates and pregnant women.Results The incidence of neonatal hypoglycemia in training set patients was 68.38%.There is a linear positive correlation between the level of serum adipose factor and the occurrence of neonatal hypoglycemia.Serum adipose factor levels have a certain predictive value for neonatal hypoglycemia(AUC=0.733).Multivariate analysis showed that premature delivery,intrauterine infection,low birth weight,neonatal asphyxia,neonatal diarrhea,and serum adipose factor levels were independent risk factors for neonatal hypoglycemia(P<0.05).The prediction model has a good prediction performance.The incidence of complications in patients with abnormal serum adipose factor levels were significantly higher than the normal serum adipose factor levels group(P<0.05).Conclusion Serum adipose factor levels in the late pregnancy of patients with gestational diabetes have a significant impact on neonatal hypoglycemia and related complications.Serum adipose factor levels have a predictive value for neonatal hypoglycemia.