妊娠期糖尿病孕妇孕期血糖代谢情况与新生儿血糖、肾功能及胆红素代谢的相关性

Association analysis of glucose metabolism during pregnancy in pregnant women with gestational diabetes mellitus with neonatal glucose,renal function and bilirubin metabolism

目的 分析妊娠期糖尿病(GDM)孕妇孕期糖代谢情况与新生儿血糖、肾功能及胆红素代谢的相关性。方法 选取宣城市人民医院在2021年1月至2023年3月期间收治的95例GDM患者及所分娩的新生儿进行研究,GDM产妇根据分娩完成时的血糖水平分为血糖控制理想组与血糖控制不佳组;另选取同期妊娠的100名健康产妇及所分娩的新生儿为对照组。比较三组产妇妊娠完成时的血糖水平;比较三组新生儿入住新生儿科时的血糖值、血红蛋白及血钙水平;比较三组新生儿入住新生儿科时的肾功能指标[血尿素氮(BUN)、血肌酐(SCr)];比较三组新生儿入住新生儿科时的胆红素代谢情况[总胆红素(TBil)、直接胆红素(DBil)以及间接胆红素(IBil)];分析新生儿血糖水平、肾功能、胆红素水平与GDM产妇血糖代谢的相关性。结果 95例患者中,有54例患者血糖控制理想(血糖控制理想组),41例患者血糖控制不佳(血糖控制不佳组)。血糖控制不佳组的空腹血糖、糖化血红蛋白、餐后2 h血糖均高于对照组、血糖控制理想组,差异均有统计学意义(P<0.05);新生儿出生时血糖值、血钙水平:对照组>血糖控制理想组>血糖控制不佳组,血红蛋白、SCr、TBil、IBil水平:对照组<血糖控制理想组<血糖控制不佳组,差异均有统计学意义(P<0.05);新生儿血糖、血钙水平与GDM产妇血糖代谢呈负相关,血红蛋白、SCr、TBil、IBil水平与GDM产妇血糖代谢呈正相关(P<0.05)。结论 GDM对胎儿及新生儿影响较大,应加强妊娠期血糖控制,密切关注GDM产妇所生新生儿血糖、肾功能及胆红素代谢情况,防止并发症的发生。

Objective To analyse the association between glucose metabolic profile during preg-nancy in pregnant women with gestational diabetes mellitus and neonatal glucose,renal function and bilirubin metabolism.Methods Ninety-five newborns delivered by GDM patients admitted to Xuancheng People's Hos-pital from January 2021 to March 2023 were retrospectively selected for the study,and 100 neonates delivered by healthy mothers in the same period of gestation were selected as the control group.The blood glucose levels at the end of pregnancy were compared among the three groups;the blood glucose,hemoglobin and calcium levels of the three groups were compared when checked into the neonato logy department.Renal function index-es[Blood urea nitrogen(BUN)and Serum Creatinine(SCr)]were compared among the three groups when checked into the neonato logy department.The bilirubin metabolism of the three groups of neonates when checked into the neonato logy department[Total bilirubin(TBil),direct bilirubin(DBil)and Indirect biliru-bin(IBil)]were also compared.Additionally,the correlation between neonatal blood glucose levels,renal function,bilirubin levels and maternal glucose metabolism in GDM were analyzed.Results Among the 95 patients,54 had ideal blood glucose control(ideal blood glucose control group)and 41 had poor blood glu-cose control(poor blood glucose control group).Fasting blood glucose,glycated hemoglobin and 2-hour post-prandial blood glucose in the poor blood glucose control group were higher than those in the control group and ideal blood glucose control group.The differences were statistically significant(P<0.05).The blood glucose values and blood calcium levels of newborns at birth were as follows:control group>ideal blood glucose con-trol group>poorly controlled blood glucose control group.Hemoglobin levels were:control group<ideal blood glucose control group<poorly controlled blood glucose control group.Hemoglobin,SCr,TBil and IBil levels were:control group<ideal blood glucose control group<poor blood glucose control group.The differences were statistically significant(P<0.05).The levels of blood glucose and blood calcium in newborns were nega-tively correlated with the blood glucose metabolism of GDM mothers,while the levels of hemoglobin,SCr,TBil and IBil were positively correlated with the blood glucose metabolism of GDM mothers.These differences were statistically significant(P<0.05).Conclusion GDM has a significant impact on fetuses and newborns.It is important to enhance blood glucose control during pregnancy and closely monitor the blood glucose levels,re-nal function and bilirubin metabolism of newborns born to mothers with GDM in order to prevent complications.