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| Risk Factors Analysis and Prediction Model of Early Hypoglycemia in Newborns with Gestational Diabetes Mellitus |
| HUANG Liyun |
| Department of Gynaecology and Obstetrics,Quanzhou Guangqian Hospital,Quanzhou Fujian 362321 |
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Abstract 【Objective】To investigate the risk factors of early neonatal hypoglycemia in patients with gestational diabetes mellitus (GDM) and establish a predictive model. 【Methods】A total of 193 GDM patients and their neonates who gave birth in the obstetrics and Gynecology Department of our hospital from June 2020 to December 2023 were selected, and the neonates were divided into hypoglycemic group (n=45) and normal glycemic group (n=148) according to the early blood glucose level of the neonates. Univariate and multivariate Logistic regression were used to analyze the influencing factors of early neonatal hypoglycemia, and the predictive forest map model was built accordingly. Receiver operating characteristic (ROC) curve was used to evaluate the model performance, and the nomogram model was drawn with R4.3.0 software, and the differentiation of the model was evaluated by ROC curve. Bootstrap method was used to conduct 1000 repeated samples to verify the prediction efficiency of the forest map model. 【Results】The hypoglycemic group had poor prenatal body mass index and blood glucose control during pregnancy, the delivery mode was cesarean section, the proportion of neonatal low body weight was significantly higher than that of the normal blood glucose group, the proportion of family history of diabetes, and the Apgar score were lower than that of the normal blood glucose group. Logistic regression analysis results showed: High prenatal body mass index, poor glycemic control during delivery, cesarean section delivery and low birth weight were risk factors for early hypoglycemia in newborns (P<0.05), while family history of diabetes and high Apgar score were protective factors for early hypoglycemia in newborns (P<0.05). The model verification results showed that the model had high sensitivity and specificity.【Conclusion】This study identified the risk factors for early hypoglycemia in newborns with GDM, and constructed a risk prediction model with good predictive performance, which can be used as a clinical assessment tool to predict the risk of early hypoglycemia in newborns with GDM.
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Received: 01 July 2024
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[1] 肖瑾,马丽娴,石燕. 妊娠阶段的强化护理干预对妊娠期糖尿病孕产妇妊娠结局的影响[J].海军医学杂志,2019,40(4):358-360.
[2] HERSH R A ,RYAN K ,MADDING R , et al. Delivery hospitalization costs associated with diabetic ketoacidosis among pregnant patients with pre-existing diabetes[J].Am J Obstet Gynecol,2024,230(S1):S260-S261.
[3] CHMIELIAUSKAITE M, GROSH M D , SYED A, et al.A pregnant patient with gestational diabetes reports for scaling and root planning[J].Dent Clin North Am,2023,67(4):707-709.
[4] 中华医学会妇产科学分会产科学组,中华医学会围产医学分会,中国妇幼保健协会妊娠合并糖尿病专业委员会. 妊娠期高血糖诊治指南(2022) [J].中华妇产科杂志,2022,57(1):3-12.
[5] 中华医学会儿科学分会新生儿学组. 新生儿低血糖临床规范管理专家共识(2021)[J].中国当代儿科杂志,2022,24(1):1-13.
[6] 江苏省新生儿重症监护病房母乳喂养质量改进临床研究协作组. 极低/超低出生体重儿生后1 min低Apgar评分的危险因素:多中心回顾性研究[J].中国当代儿科杂志,2023,25(9):909-914.
[7] 吴蕾,韩研,吕骥,等. 妊娠期糖尿病孕妇血清AHSG、PAPP-A水平及与妊娠结局关系[J].中国计划生育学杂志,2023,31(3):628-631.
[8] 毛郑霞,张红飞,包正荣,等. 妊娠期糖尿病孕妇分娩前糖化血红蛋白与新生儿血糖及出生体重的相关性分析[J].中华糖尿病杂志,2022,14(1):38-42.
[9] 韩静,尹卫,步红兵,等. 新生儿低血糖风险预测模型的构建与临床应用研究[J].护士进修杂志,2022,37(1):31-36.
[10] 冯彩丽,冀京雷,冯会敏,等. 基于logistic回归分析EENC对早产儿体格生长及临床结局的影响[J].重庆医学,2022,51(3):459-463.
[11] 赵艾菊,蔡莉君. 早产儿早期低血糖的发生率及危险因素研究[J].中国实验诊断学,2021,25(5):650-654.
[12] 何乐英. 规范化综合营养干预对妊娠期糖尿病孕妇血红蛋白和妊娠结局的影响[J].中国妇幼保健,2022,37(16):2949-2952.
[13] 多妍蓓,赵维纲. 妊娠糖尿病产后发生2型糖尿病的危险因素及早期预测研究进展[J].中国实用内科杂志,2021,41(11):990-994.
[14] 左喜芳,韩晓洁,韩松筠,等. 双胎妊娠子痫前期的临床危险因素及围生儿结局分析[J].中国医刊,2023,58(7):767-773.
[15] 张少艳,张玮,赵晓啦,等. 新生儿低血糖相关危险因素的Logistic回归分析及集束化管理[J].中国妇幼保健,2022,37(19):3605-3608. |
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2024, Vol. 41 
