中华实用儿科临床杂志
中華實用兒科臨床雜誌
중화실용인과림상잡지
Journal of Applied Clinical Pediatrics
2015年
1期
46-49
,共4页
妊娠期糖尿病母亲%糖耐量减低%糖尿病母亲婴儿%心脏合并症
妊娠期糖尿病母親%糖耐量減低%糖尿病母親嬰兒%心髒閤併癥
임신기당뇨병모친%당내량감저%당뇨병모친영인%심장합병증
Gestational diabetic mother%Impaired glucose tolerance%Infants of diabetic mother%Cardiac complication
目的 探讨糖尿病母亲婴儿(infants of diabetic mothers,IDMs)发生心脏合并症的高危因素.方法 对2011年1月至2014年4月在北京大学深圳医院儿科228例IDMs进行调查,其中其母亲妊娠期资料完整者共171例.于出生后1周内择期完成心脏B超检查.将IDMs依据B超检查结果分为2组:观察组(有心脏合并症)及对照组(心脏正常).将患儿情况与母亲妊娠期的状况相结合进行分析比较.结果 观察组69例(男38例、女31例),对照组102例(男59例、女43例);观察组早产儿24例,对照组47例;观察组大于胎龄儿(LGA) 16例,对照组LGA 15例;经检验,2组在性别、是否早产儿、是否LGA方面差异均无统计学意义(x2=0.129、2.163、1.995,P均＞0.05).观察组新生儿低血糖7例(4.1％),高于对照组[1例(0.6％)],2组比较差异有统计学意义(x2 =7.752,P ＜0.05);观察组高龄产妇者24例(14.0％),高于对照组[19例(11.1％)],2组比较差异有统计学意义(x2=5.707,P＜0.05);观察组有其他合并症的母亲24例(14.0％),高于对照组[15例(8.8％)],2组比较差异有统计学意义(x2 =9.423,P＜0.01);观察组孕母血糖控制好者19例(11.1％),低于对照组[80例(46.8％)],2组比较差异有统计学意义(x2=43.735,P＜0.01);观察组仅糖耐量减低母亲9例(5.3％),低于对照组[26例(15.2％)],2组比较差异有统计学意义(x2=3.917,P＜0.05).Logistic回归分析显示,母亲有其他合并症为患儿出现心脏合并症的危险因素(OR=3.29,95％ CI1.248 ～8.671),血糖控制满意为其保护因素(OR =0.098,95％CI0.045 ～0.217).结论 在患妊娠糖尿病母亲中,孕期血糖控制差、有其他合并症、高龄产妇以及母亲糖尿病较严重者所生新生儿易出现心脏合并症.
目的 探討糖尿病母親嬰兒(infants of diabetic mothers,IDMs)髮生心髒閤併癥的高危因素.方法 對2011年1月至2014年4月在北京大學深圳醫院兒科228例IDMs進行調查,其中其母親妊娠期資料完整者共171例.于齣生後1週內擇期完成心髒B超檢查.將IDMs依據B超檢查結果分為2組:觀察組(有心髒閤併癥)及對照組(心髒正常).將患兒情況與母親妊娠期的狀況相結閤進行分析比較.結果 觀察組69例(男38例、女31例),對照組102例(男59例、女43例);觀察組早產兒24例,對照組47例;觀察組大于胎齡兒(LGA) 16例,對照組LGA 15例;經檢驗,2組在性彆、是否早產兒、是否LGA方麵差異均無統計學意義(x2=0.129、2.163、1.995,P均＞0.05).觀察組新生兒低血糖7例(4.1％),高于對照組[1例(0.6％)],2組比較差異有統計學意義(x2 =7.752,P ＜0.05);觀察組高齡產婦者24例(14.0％),高于對照組[19例(11.1％)],2組比較差異有統計學意義(x2=5.707,P＜0.05);觀察組有其他閤併癥的母親24例(14.0％),高于對照組[15例(8.8％)],2組比較差異有統計學意義(x2 =9.423,P＜0.01);觀察組孕母血糖控製好者19例(11.1％),低于對照組[80例(46.8％)],2組比較差異有統計學意義(x2=43.735,P＜0.01);觀察組僅糖耐量減低母親9例(5.3％),低于對照組[26例(15.2％)],2組比較差異有統計學意義(x2=3.917,P＜0.05).Logistic迴歸分析顯示,母親有其他閤併癥為患兒齣現心髒閤併癥的危險因素(OR=3.29,95％ CI1.248 ～8.671),血糖控製滿意為其保護因素(OR =0.098,95％CI0.045 ～0.217).結論 在患妊娠糖尿病母親中,孕期血糖控製差、有其他閤併癥、高齡產婦以及母親糖尿病較嚴重者所生新生兒易齣現心髒閤併癥.
목적 탐토당뇨병모친영인(infants of diabetic mothers,IDMs)발생심장합병증적고위인소.방법 대2011년1월지2014년4월재북경대학심수의원인과228례IDMs진행조사,기중기모친임신기자료완정자공171례.우출생후1주내택기완성심장B초검사.장IDMs의거B초검사결과분위2조:관찰조(유심장합병증)급대조조(심장정상).장환인정황여모친임신기적상황상결합진행분석비교.결과 관찰조69례(남38례、녀31례),대조조102례(남59례、녀43례);관찰조조산인24례,대조조47례;관찰조대우태령인(LGA) 16례,대조조LGA 15례;경검험,2조재성별、시부조산인、시부LGA방면차이균무통계학의의(x2=0.129、2.163、1.995,P균＞0.05).관찰조신생인저혈당7례(4.1％),고우대조조[1례(0.6％)],2조비교차이유통계학의의(x2 =7.752,P ＜0.05);관찰조고령산부자24례(14.0％),고우대조조[19례(11.1％)],2조비교차이유통계학의의(x2=5.707,P＜0.05);관찰조유기타합병증적모친24례(14.0％),고우대조조[15례(8.8％)],2조비교차이유통계학의의(x2 =9.423,P＜0.01);관찰조잉모혈당공제호자19례(11.1％),저우대조조[80례(46.8％)],2조비교차이유통계학의의(x2=43.735,P＜0.01);관찰조부당내량감저모친9례(5.3％),저우대조조[26례(15.2％)],2조비교차이유통계학의의(x2=3.917,P＜0.05).Logistic회귀분석현시,모친유기타합병증위환인출현심장합병증적위험인소(OR=3.29,95％ CI1.248 ～8.671),혈당공제만의위기보호인소(OR =0.098,95％CI0.045 ～0.217).결론 재환임신당뇨병모친중,잉기혈당공제차、유기타합병증、고령산부이급모친당뇨병교엄중자소생신생인역출현심장합병증.
Objective To discuss the risk factors for cardiac complications in infants of diabetic mothers (IDMs).Methods One hundred and seventy-one out of 228 IDMs hospitalized in Department of Pediatrics,Shenzhen Hospital of Peking University from Jan.2011 to Apr.2014,were involved,among them,there were 171 cases who had the complete mother's data during pregnancy,and they were received B ultrasonography whin 1 week after birth.All the infants were divided into 2 groups according to echocardiography within 1 week after birth:the observation group (the patients had cardiac complications) and the control group (the patients had normal heart).Conditions of IDMs and their mothers between the 2 groups were recorded and compared.Results In the 171 IDMs,there were 69 cases(38male and 31 female) in the observation group and 102 cases(59 males and 43 females) in the control group.There were 24 preterm infants,16 large for gestational age(LGA) infants in the observation group,while 47 preterm infants and 15 LGA in the control group,and which had no statistical difference between the both groups(x2 =0.129,2.163,1.995 ; all P ＞ 0.05).In the observation group,there were 7 (4.1％) newborns with hypoglycemia,24 (14.0％) women with advanced maternal age,24(14.0％) women with other gestational complications,19(11.1％) women having good control of their glucose serum levels,and 9(5.3％) women with impaired glucose tolerance.All the mentioned factors had statistical differences when compared with the control group[1 (0.6％) case,19 (11.1％) cases,15 (8.8％) cases,80(66.8％) cases,26(15.2％) cases] (x2 =7.752,5.707,9.423,43.735,3.917 ;all P ＜ 0.05,0.01).Logistic regression showed that women with other gestational complications as risk factors(OR =3.29,95％ CI 1.248-8.671),while having a good control of the glucose serum levels acted as a protectable factor(OR =0.098,95％ CI 0.045-0.217).Conclusions IDMs are prone to have cardiac complications if their mothers couldn't control the glucose serum levels during pregnancy,with other gestational complication and advanced maternal age and with more serious diabetes.
