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在患有糖尿病的个体中,产后连续血糖监测值和新生儿低血糖症之间的关系
Michal Fishel Bartal1,2, Sarah A Nazeer1, 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
|December 2, 2024
概括
糖尿病患者在分娩期间持续监测血糖 (CGM) 是可行的. 产内CGM时间超过范围 (TAR) 与新生儿低血糖症 (NH) 的更高发病率有关.
科学领域:
- 产科和妇科 产科和妇科
- 内分泌学 在内分泌学.
- 新生儿科学 新生儿科学
背景情况:
- 怀孕期间的糖尿病需要仔细的产后葡萄糖管理.
- 持续血糖监测 (CGM) 在分娩期间提供了详细的血糖概况.
- 在糖尿病怀孕中预测新生儿低血糖症 (NH) 仍然是一个临床挑战.
研究的目的:
- 评估产后持续血糖监测 (CGM) 与新生儿低血糖症 (NH) 之间的关联.
- 评估CGM对糖尿病患者劳动中的NH的预测能力.
- 确定CGM衍生的葡萄糖指标的最佳值,用于预测NH.
主要方法:
- 一项多中心前性研究,涉及患有糖尿病 (妊娠≥34周) 的劳动力个体.
- 盲目CGM放置从入院到分娩,同时进行指针 (FS) 监测.
- 分析目标范围内的时间 (TIR) 和超出范围的时间 (TAR),以及它们与NH和其他新生儿结局的相关性.
主要成果:
- 产内CGM在分娩期间提供了完整的葡萄糖概况.
- 超过61%的超值时间 (TAR) 被确定为NH的最佳预测指标.
- 发现CGM和FS都是NH的差预测指标,预测精度 (AUC) 没有显著差异.
结论:
- 产内CGM是一种可行的方法,用于监测糖尿病患者在分娩期间的葡萄糖水平.
- 产后CGM时间高于范围 (TAR>61%) 与新生儿低血糖症的风险增加有关.
- 虽然可行,但单独CGM和FS的预测能力对新生儿低血糖症的预测能力有限.
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