基于孕妇分娩因素构建新生儿低血糖预警模型的应用价值  

Application value of neonatal hypoglycemia warning model based on delivery factors of pregnant women

作　　者：刘丽 曹云 詹远 LIU Li;CAO Yun;ZHAN Yuan(Jiangsu Provincial Hospital(The First Affiliated Hospital of Nanjing Medical University),Nanjing,Jiangsu Province,210009)

机构地区：[1]江苏省人民医院(南京医科大学第一附属医院),南京210009

出　　处：《中国计划生育学杂志》2022年第12期2787-2791,共5页Chinese Journal of Family Planning

摘　　要：目的:探究新生儿低血糖发生高危因素并建立预警模型。方法:选择本院2019年1月-2020年12月住院待产的初产妇,随机筛选200例作为研究对象,分析不同分娩因素新生儿低血糖发生率差异,多因素logistic回归分析其高危因素,采用列线图构建新生儿低血糖预警模型,并另选取同期20例初产妇作为预警模型验证对象(对照组),绘制受试者工作特征曲线(ROC)进行验证。结果:观察组200名新生儿低血糖发生率为8.0%;妊娠期糖尿病孕妇分娩的新生儿低血糖发生率高于未患妊娠期糖尿病孕妇,早产儿、小于胎龄儿、巨大儿、低体温、低出生体重的新生儿低血糖发生率升高,新生儿低血糖发生的高危因素包括妊娠期糖尿病、早产儿、小于胎龄儿、巨大儿、低体温、低出生体重(均P<0.05);新生儿低血糖预警模型是4.734-3.486×妊娠期糖尿病-3.507×小于胎龄儿-4.572×巨大儿-3.510×低体温+3.924×早产儿+1.504×低出生体重,曲线下面积0.800,诊断敏感度87.5%、特异度75.0%、。结论:新生儿发生低血糖的高危因素是妊娠期糖尿病、早产儿、小于胎龄儿、巨大儿、低体温、低出生体重,构建的预警模型对新生儿低血糖预测有较好预测价值。Objective:To explore the high-risk factors of neonatal hypoglycemia,and to establish warning model of neonatal hypoglycemia.Methods:A total of 200 primipara who had hospitalized for delivery were randomly selected as the research objects from J anuary 2019 to December 2020.The differences of the incidence of neonatal hypoglycemia of these primipara with different delivery factors were analyzed.The high-risk factors of the neonatal hypoglycemia were analyzed by multivariate Logistic regression.A nomogram was used to construct the warning model of the neonatal hypoglycemia,and another 20 primiparas during the same period were selected as the verification objects of this warning model.Receiver operating characteristic(ROC)curve was drawn for verifying this model.Results:The incidence of neonatal hypoglycemia of these 200 primipara was 8.0%.The incidence of neonatal hypoglycemia of the primipara with gestational diabetes mellitus(GDM)was significantly higher than that of the primipara without GDM.The incidence of hypoglycemia of premature infants,infants small for gestational age,macrosomia,neonatal hypothermia,or low neonatal birth weight had increased.The risk factors of neonatal hypoglycemia included GDM,preterm birth,small for gestational age,macroia,hypothermia,and low birth weight(all P<0.05).The warning model of neonatal hypoglycemia was 4.734-3.486×GDM-3.507×small for gestational age-4.572×megalosia-3.510×hypothermia+3.924×preterm infant+1.504×low birth weight,and the area under the curve,the sensitivity,and the specificity of which for diagnosing neonatal hypoglycemia were 0.800,87.5%,and 75.0%,respectively.Conclusion:The high-risk factors of neonatal hypoglycemia include GDM,premature infants,infants small for gestational age,hypothermia,and low birth body mass.The warning model has better predictive efficacy for neonatal hypoglycemia.

关 键 词：新生儿低血糖 高危因素 预警模型 诊断效能 

分 类 号：R714.7[医药卫生—妇产科学]