对于妊娠年龄和不良结果来说很大:按糖尿病状况分层
Sarah A Nazeer1, Han-Yang Chen1, Joycelyn Ashby Cornthwaite1
1Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology, and Reproductive Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, Texas.
American journal of perinatology
|April 30, 2024
概括
对于妊娠年龄大 (LGA) 的新生儿及其母亲的不良结果在糖尿病存在时显著更高. 这些发现强调了在怀孕期间管理糖尿病的重要性,以改善孕产妇和新生儿的健康状况.
科学领域:
- 产科和妇科 产科和妇科
- 新生儿科学 新生儿科学
- 内分泌学 在内分泌学.
背景情况:
- 对于妊娠年龄 (LGA) 的新生儿来说,大个体与增加对母亲和新生儿不良结果的风险有关.
- 母亲糖尿病状况对LGA新生儿这些风险的影响需要进一步调查.
研究的目的:
- 分析母亲糖尿病与LGA新生儿怀孕中不良结果之间的关联.
- 描述LGA新生儿不良结果的时间趋势,按糖尿病状况分层.
主要方法:
- 使用美国生命统计数据集 (2014-2020) 的回顾性队列研究.
- 纳入标准:单独的,非异常的LGA活产 (24-41周),已知糖尿病状况.
- 首要结局:综合新生儿 (Apgar <5,长时间通风,,死亡率) 和母亲 (输血,子宫破裂,子宫切除,ICU入院,计划外手术) 的不良事件.
- 使用了多变量波桑回归和AAPC分析.
主要成果:
- 在2700万个出生中,有180万个符合纳入标准;10.1%患有糖尿病.
- 与没有糖尿病的人相比,糖尿病患者的新生儿 (aRR=1.48) 和母亲 (aRR=1.37) 的综合不良结果显著更高.
- 在非糖尿病患者中,LGA率保持稳定,但在糖尿病患者中呈现下降趋势 (AAPC=-2.4%).
结论:
- 孕产妇糖尿病与LGA新生儿怀孕中新生儿和孕产妇综合不良结果显著增加有关.
- 这些发现强调了在怀孕期间谨慎管理糖尿病的关键需要,以减轻母亲和孩子的风险.
- 时间趋势表明,糖尿病患者的LGA发病率正在下降,而没有糖尿病患者的LGA发病率保持稳定.
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