孕前糖尿病产妇分娩的新生儿发生低血糖的高危因素和潜在风险分析

Analysis of high risk factors and potential risks of hypoglycemia in newborns delivered by pregestational diabetes mellitus pregnanct women

目的研究孕前糖尿病产妇分娩的新生儿发生低血糖的危险因素,并进行潜在聚类,以识别出具有不同危险因素的孕前糖尿病患者中高风险的患者。方法以孕前糖尿病产妇分娩的新生儿为研究对象,选取高龄、妊娠期体质量增加过度、不良孕产个人史、糖尿病家族史、妊娠合并高血压、糖化血红蛋白异常(≥6.5%)、早产、巨大儿、分娩方式9个新生儿低血糖危险因素作为显变量,进行潜在类别分析。结果潜在类别分析将9个危险因素划分为两个潜在类别,分别为普通组和高危组。个体聚类后普通组与高危组孕前糖尿病产妇分娩的新生儿低血糖发生率为60.4%和29.8%,差异具有统计学意义(χ~2=35.769,P<0.001)。结论根据潜在类别结果可筛选出孕前糖尿病产妇分娩的新生儿发生低血糖的高危人群,并为该类患者的针对性护理干预提供依据。

Objective To study the risk factors of hypoglycemia in newborns delivered by pregestational diabetes mellitus pregnanct women,and conduct the potential clustering to identify high-risk patients from pregestational diabetes mellitus pregnancy with different risk factors.Methods Taking the newborns delivered by pregestational diabetes mellitus pregnanct women as the research objects,the potential category analysis was carried out by selecting nine risk factors of neonatal hypoglycemia as observed variables,including the elderly,excessive weight gain during pregnancy,personal history of poor pregnancy,family history of diabetes,pregnancy with hypertension,abnormal glycosylated hemoglobin(≥6.5%),premature delivery,macrosomia,and delivery mode.Results By performing a latent class analysis,the nine risk factors were classified into two potential categories,namely,general group and high risk group.After individual clustering,the incidence of hypoglycemia of newborns delivered by pregestational diabetes mellitus pregnant women in general group and high risk group was 60.4%and 29.8%,respectively,with a statistically significant difference(χ~2=35.769,P<0.001).Conclusion Potential categories can screen out the high-risk groups for hypoglycemia in newborns delivered by pregestational diabetes mellitus pregnanct women,which provide a basis for targeted nursing intervention for such patients.