Clinical features and prognosis of neonatal hypoglycemia and analysis of risk factors
Pan Xi 'an, Jiang Qiushi, Jiang Huidi, et al
(1. Department of Pediatrics, the ThirdPeople 's Hospital of Hefei, Anhui, Hefei 230022, China; 2. Department of Pediatrics, Binhu Hospital, Anhui,Hefei 230092, China)
Abstract: 【Abstract】 Objective To evaluate the clinical features and prognosis of neonatal hypoglycemia, and perform analysis on its risk factors. Method A retrospective analysis was performed on 58 children with neonatal hypoglycemia (hypoglycemia group) in the Third People's Hospital of Hefei from January 2019 to January 2022. 58 neonates who were hospitalized during the same time period and had normal blood glucose monitoring were randomly selected as control group by systematic sampling. The clinical symptoms and prognosis of hypoglycemia group were analyzed. The risk factors for occurrence of neonatal hypoglycemia were evaluated. Statistical methods performed by χ2 test, Fisher exact probability method and multivariate Logistic regression analysis. Result Most of the clinical symptoms were asymptomatic [48.3% (28/58)],followed by cyanosis [19.0% (11/58)] and moaning [15.5% (9/58)]. Neonatal pneumonia was the most common comorbidity [84.5% (49/58)], followed by hyperbilirubinemia [25.9% (15/58)] and ischemichypoxic myocardial injury [17.2% (10/58)]. Among the 58 children with neonatal hypoglycemia, there were 11 cases [19.0% (11/58)] of hypoglycemic brain injury, and their condition improved after 1 to 2 weeks of treatment, and 8 cases of them were followed up for 1 year without any sequelae. The other 47 cases with neonatal hypoglycemia but without brain injury were cured and discharged after treatment without sequelae.Univariate analysis showed that the proportion of preterm infants in the hypoglycemic group [25.9% (15/58)vs 10.3% (6/58), χ2=4.710, P=0.030] and the age <1 d [(69.1% (40/58) vs 46.6% (27/58), χ2=7.696, P=0.021)were higher than those in the control group; the rate of cesarean section [65.5% (38/58) vs 20.7% (12/58),χ2=23.762, P<0.001], the rate of unopened milk [60.3% (35/58) vs 10.3% (6/58), χ2=33.474, P<0.001], theincidence of gestational hypertension [19.0% (11/58) vs 3.5% (2/58), χ2=7.017, P=0.008], and the incidenceof gestational diabetes mellitus[ 43.1% (25/58) vs 8.6% (5/58), χ2=17.985, P<0.001]were higher than those in the control group . Regression analysis showed that premature infants (OR=1.719, 95% CI: 1.005-3.961),age<1 day (OR=2.044, 95% CI: 1.096-4.327), cesarean section (OR=3.016, 95% CI: 1.745-5.216), nonlactation(OR=2.672, 95% CI: 1.472-4.851), gestational hypertension (OR=2.450, 95% CI: 1.248-4.809) andgestational diabetes mellitus (OR=3.080, 95% CI: 1.774-5.347) were risk factors for neonatal hypoglycemia(all P<0.05). Conclusion Premature infants, age<1 day, cesarean section, non-lactation, gestationalhypertensive disease and gestational diabetes mellitus are many risk factors for neonatal hypoglycemia. It is necessary to pay clinical attention to screening and identification and timely perform symptomatic treatment.
潘西安 姜秋实 蒋慧娣 姚君 黄金华. 新生儿低血糖的临床特征、预后及其危险因素分析[J]. 发育医学电子杂志, 2024, 12(1): 36-40.
Pan Xi 'an, Jiang Qiushi, Jiang Huidi, et al. Clinical features and prognosis of neonatal hypoglycemia and analysis of risk factors. Journal of Developmental Medicine(Electronic Version), 2024, 12(1): 36-40.