糖尿病母亲新生儿先天性心脏病筛查及危险因素分析

Screening Data and Risk Factor of Congenital Heart Disease in Neonates With Diabetes Mothers

目的探讨糖尿病母亲新生儿先天性心脏病的发病情况及患先天性心脏病的危险因素,为妊娠合并糖尿病母亲新生儿预防先天性心脏病提供参考依据。方法通过江门市新生儿先天性心脏病筛查方案对台山市人民医院产科2021年3月—2022年12月出生的糖尿病母亲的201例活产新生儿进行先天性心脏病筛查,采用病例对照研究方法,经超声心动图确诊的先天性心脏病新生儿为研究组,同期检查的正常新生儿为对照组,统计糖尿病母亲新生儿先天性心脏病的发病情况,对比糖尿病母亲活产新生儿先天性心脏病患儿与健康儿筛查资料并分析其危险因素。结果糖尿病母亲新生儿先天性心脏病的发病率为11.94%,疾病分布占比从高到低分别为房间隔缺损、动脉导管未闭、房间隔缺损合并动脉导管未闭、室间隔缺损。单因素分析显示,研究组糖尿病合并妊娠(pregestational diabetes mellitus,PGDM)、母亲年龄≥35岁、母亲低学历(高中以下)、血糖控制差、妊娠疾病、烟草暴露占比均高于对照组(P<0.05)。将上述单因素分析差异有统计学意义的因素纳入多因素Logistic回归分析发现,PGDM、母亲年龄≥35岁、血糖控制差、妊娠疾病、烟草暴露均是先天性心脏病发生的独立危险因素(P<0.05)。结论糖尿病母亲新生儿先天性心脏病发病率高。新生儿先天性心脏病的影响因素包括糖尿病类型、母亲年龄≥35岁、血糖控制差、妊娠疾病、烟草暴露。

Objective To investigate the incidence and risk factors of congenital heart disease in newborns of diabetic mothers,and to provide reference for the prevention of congenital heart disease in newborns of pregnant mothers complicated with diabetes.Methods Congenital heart disease screening was performed on 201 live newborns of diabetic mothers born in the department of obstetrics,Taishan People's Hospital from March 2021 to December 2022through the Jiangmen Newborn congenital heart Disease screening program.The case-control study method was adopted.Neonates diagnosed with congenital heart disease by echocardiography were the study group,and normal neonates examined during the same period were the control group.The incidence of congenital heart disease in newborns of diabetic mothers was analyzed.The screening data of congenital heart disease in newborns of diabetic mothers and healthy infants were compared,and the risk factors were analyzed.Results The incidence of congenital heart disease in newborns of diabetic mothers was 11.94%,and the proportion of disease distribution from high to low was atrial septal defect,patent ductus arteriosus,atrial septal defect combined with patent ductus arteriosus,and ventricular septal defect.Univariate analysis showed that the proportion of pregestational diabetes mellitus complicated with pregestational diabetes mellitus(PGDM),maternal age ≥ 35 years old,low maternal education(lower than high school),poor blood glucose control,gestational diseases and tobacco exposure in the study group was higher than that in the control group(P<0.05).Factors with statistically significant differences in the above univariate analysis were incorporated into multivariate Logistic regression analysis,and it was found that PGDM,maternal age ≥ 35 years old,poor blood sugar control,pregnancy diseases,and tobacco exposure were all independent risk factors for congenital heart disease(P<0.05).Conclusion The incidence of congenital heart disease in newborns of diabetic mothers is high.Factors affecting congenital heart disease in newborns include type of diabetes,maternal age ≥ 35 years,poor blood sugar control,pregnancy disease,and tobacco exposure.