新生儿低血糖症围产期潜在危险因素分析

Analysis of potential risk factors for neonatal hypoglycemia during the perinatal period

目的探讨发生新生儿低血糖症(NH)的相关危险因素,减少NH及并发症的发生,为临床提供有效的预防及干预治疗,规范管理NH提供参考依据。方法对柳州市中医医院2020年7月至2023年6月产科出生的新生儿进行血糖监测,选取1680例,按照血糖测定值分为低血糖组(70例)、正常血糖组(1610例),建立一个研究队列,采集新生儿及母亲的临床资料,采用t检验、χ^(2)检验和logistic回归分析等进行统计学分析。结果母亲年龄≥35岁、分娩方式、胎盘早剥、前置胎盘、脐带绕颈、妊娠高血压或子痫、妊娠糖尿病、母亲肥胖、产前使用地塞米松、早产儿、低体重儿、巨大儿均是NH的影响因素(P<0.05)。多因素logistic回归分析发现,妊娠糖尿病、母亲肥胖、妊娠高血压或子痫、早产儿、低体重儿、母亲年龄≥35岁是NH的主要危险因素。结论早产儿、低体重儿,母亲年龄≥35岁、母亲肥胖、妊娠糖尿病、妊娠高血压或子痫是NH的主要危险因素。生后应常规予新生儿血糖监测,早发现,早诊断,防治NH及低血糖性脑损伤等并发症,有显著的临床意义。

Objective To explore the relevant risk factors for neonatal hypoglycemia(NH),in order to reduce the occurrence of NH and complications,provide effective prevention and intervention treatment for clinical practice,and provide reference for standardized management of NH.Methods Blood glucose monitoring was conducted on newborns born in the Obstetrical Department of Liuzhou Traditional Chinese Medicine Hospital from July 2020 to June 2023.1680 cases were selected and divided into hypoglycemic group(70 cases)and normal blood glucose group(1610 cases)according to blood glucose measurement values.A study cohort was established,and clinical data of newborns and mothers were collected.Statistical analysis was conducted using t-tests,chi square tests,and logistic regression analysis.Results The maternal age≥35 years old,delivery mode,placental abruption,placenta previa,umbilical cord around the neck,pregnancy-induced hypertension or eclampsia,pregnancy-induced diabetes,maternal obesity,prenatal use of dexamethasone,premature infants,low birth weight infants and macrosomia were all influencing factors of NH(P<0.05).Multivariate logistic regression analysis found that pregnancy-induced diabetes,maternal obesity,pregnancy-induced hypertension or eclampsia,premature infants,low birth weight infants and maternal age≥35 years old were the main risk factors for NH.Conclusion Premature infants,low birth weight infants,maternal age≥35 years old,maternal obesity,pregnancy-induced diabetes,pregnancy-induced hypertension or eclampsia are the main risk factors for NH.It is of great clinical significance to monitor blood glucose of newborns after birth regularly,detect and diagnose it early,and prevent and treat complications such as NH and hypoglycemic brain injury.