羊水胎粪污染对足月新生儿血糖的影响  

Effect of amniotic fluid meconium contamination on blood glucose of full-term neonates

作　　者：卢婷 樊启红[2] 王模奎[1] 宋思尊 李艳娇[4] 屈玲 曾菊 Lu Ting;Fan Qihong;Wang Mokui;Song Sizun;Li Yanjiao;Qu Ling;Zeng Ju(Neonatal Department,Yibin Hospital,Chongqing Medical University Affiliated Children's Hospital,Yibin Sichuan 644600;Neonatal Department,First Afiliated Hospital of Changjiang University,Jingzhou Hubei 434000;Pediatrics Department,Yibin Hospital,Chongqing Medical University Afiliated Children's Hospital,Yibin Sichuan 644600;Obstetrics Department,Yibin First People's Hospital,Yibin Sichuan 644000,P.R.China)

机构地区：[1]重庆医科大学附属儿童医院宜宾医院新生儿科,四川宜宾6446000 [2]长江大学附属第一医院新生儿科,湖北荆州434000 [3]重庆医科大学附属儿童医院宜宾医院儿科,四川宜宾644600 [4]宜宾市第一人民医院产科,四川宜宾6440000

出　　处：《中国计划生育和妇产科》2024年第12期72-76,共5页Chinese Journal of Family Planning & Gynecotokology

基　　金：宜宾市卫生健康委员会科研项目(项目编号:2022YW005);宜宾市第一人民医院院内科研项目(项目编号:2022-KYY-09)。

摘　　要：目的探讨不同程度的羊水胎粪污染对足月新生儿血糖的影响。方法选取宜宾市第一人民医院2022年6月至12月出生的足月新生儿为研究对象,按照羊水粪染情况分为羊水Ⅰ°Ⅱ°污染组、羊水Ⅲ°污染组、羊水清亮组,进行前瞻性研究。监测比较出生后0、3、6、12 h新生儿足跟血葡萄糖、一般情况、脐动脉血气分析、血常规等指标。结果共纳入165例研究对象,羊水Ⅰ°Ⅱ°污染组纳入37例,羊水Ⅲ°污染组61例,羊水清亮组67例。3组孕周差异有统计学意义(P<0.05),单因素Logistic回归分析发现孕周增加一周,发生羊水胎粪污染风险性增加61.8%(OR=1.618,P=0.006)。3组其他一般情况、pH、BE、LAC及WBC、Hb、NRBC比较差异无统计学意义(P>0.05)。3组发生血糖代谢紊乱比较差异无统计学意义(P>0.05)。单因素Logistic回归分析发现,羊水胎粪污染对新生儿发生血糖异常影响无统计学意义(OR=1.550,P=0.319)。3组各时段血糖值重复测量方差分析显示,羊水Ⅰ°Ⅱ°污染组血糖随时间变化趋势与其他两组存在差异(P<0.05)。结论在足月出生新生儿中,随孕周增加,发生羊水胎粪污染风险性增加;单纯羊水胎粪污染不是新生儿发生血糖代谢紊乱的高危因素。Objective To investigate the effect of different degrees of meconium contamination in amniotic fluid on blood glucose in full-term neonates.Methods Full-term newborns born in Yibin First People's Hospital from June to December 2022 were selected as the study objects,according to the fecal staining of amniotic fluid,they were divided into amniotic fluidⅠ°Ⅱ°pollution group,amniotic fluidⅢ°pollution group,and amniotic fluid clear group for prospective study.The glucose in heel blood of newborn at 0,3,6 and 12 hours after delivery,general situation,blood gas analysis and routine blood routine of umbilical artery were monitored and analyzed.Results A total of 165 subjects were included,37 in the amniotic fluidⅠ°Ⅱ°pollution group,61 in the amniotic fluidⅢ°pollution group,and 67 in the clear amniotic fluid group.The gestational age difference among the three groups was statistically significant(P<0.05),and univariate Logistic regression analysis found that the risk of amniotic fluid meconium contamination increased by 61.8%when gestational age increased by one week(OR=1.618,P=0.006).There was no significant difference in other general conditions,pH,BE,LAC,WBC,Hb and NRBC among the three groups(P>0.05).There was no significant difference in blood glucose metabolism disorder among the three groups(P>0.05).Univariate Logistic regression analysis showed that meconium contamination of amniotic fluid had no statistical significance on abnormal blood glucose in neonates(OR=1.550,P=0.319).Repeated measurements of blood glucose values at different time periods in the three groups showed that the trend of blood glucose change over time in the amniotic fluidⅠ°Ⅱ°pollution group was different from that in the other two groups(P<0.05).Conclusion In full-term newborns,with the increase of gestational age,the risk of amniotic fluid meconium contamination increases;simple amniotic fluid meconium contamination is not a high risk factor for neonatal blood glucose metabolism disorders.

关 键 词：羊水胎粪污染 新生儿 血糖 

分 类 号：R722.1[医药卫生—儿科]