GDM患者新生儿低血糖危险因素分析及风险模型构建  

Risk factors analysis and the risk model construction of the neonatal hypoglycemia of pregnant women with gestational diabetes mellitus

作　　者：潘迎宾 隋莹莹 刘春颖 PAN Yingbin;SUI Yingying;LIU Chunying(Beijing Daxing District People's Hospital,Beijing,102600)

机构地区：[1]北京市大兴区人民医院,102600

出　　处：《中国计划生育学杂志》2025年第2期425-428,433,共5页Chinese Journal of Family Planning

摘　　要：目的:分析妊娠期糖尿病(GDM)孕产妇新生儿低血糖发生危险因素并构建风险预测模型。方法:回顾性分析2020年1月-2023年1月本院收治的GDM孕产妇300例临床资料,根据其新生儿情况分为正常组56例和低血糖组244例,分析两组临床资料,采用多因素logistic回归分析新生儿低血糖发生危险因素并构建预测模型,以受试者工作特性(ROC)曲线评价该模型区分度。使用反复取样方法从1000个样本中对线性模式进行检验。结果:两组孕周、产前体质指数(BMI)、预估胎儿体质量、接受产前学习、分娩期血糖控制情况以及分娩方式存在差异(均P<0.05)。多因素logistic回归分析,产前BMI高、分娩期血糖控制不佳以及分娩方式为剖宫产是GDM产妇新生儿低血糖发生的危险因素,而孕周大、预估胎儿体质量高以及接受产前培训次数多是新生儿低血糖的保护因素(均P<0.05)。ROC曲线分析,该预测模型的曲线下面积为0.869,且该模型与真实情况一致性良好。结论:在GDM孕产妇分娩新生儿低血糖发生诸多影响因素中以孕周、产前体质指数、胎儿预估体重、产前教育、分娩期血糖状态、分娩模式建立的GDM孕妇分娩新生儿低血糖危险度的预测模式有一定临床指导意义。Objective: To analyze the risk factors of the neonatal hypoglycemia(NH) of pregnant women with gestational diabetes mellitus(GDM), and to establish a risk prediction model for evaluating the neonatal hypoglycemia of the women. Methods: The clinical data of 300 pregnant women with GDM in the hospital from January 2020 to January 2023 were analyzed retrospectively. These women were divided into control group(56 cases without the neonatal hypoglycemia) and research group(244 cases with the neonatal hypoglycemia) according to the neonatal conditions. The clinical data of the women in the two groups were analyzed. Multifactor logistic regression was used to analyze the risk factors of the neonatal hypoglycemia, and a predictive model for evaluating the neonatal hypoglycemia was constructed based on these risk factors. Receiver operating characteristic(ROC) curve was used to evaluate the discrimination for the neonatal hypoglycemia of this model. Linear pattern were tested by the repeated sampling method from 1000 samples. Results: There were significant differences in the gestational weeks, the prenatal body mass index(BMI), the estimated fetal weight, the prenatal learning, the blood glucose control situation during delivery, and the delivery mode of the women between the two groups(all P<0.05). Multivariate logistic regression analysis showed that high prenatal BMI, the poor blood glucose control during delivery and the cesarean section of the women with GDM were the risk factors of their neonatal hypoglycemia, while the gestational weeks, the higher estimated fetal weight and the more times of prenatal training of the women with GDM were the protective factors of their neonatal hypoglycemia(all P<0.05). ROC curve analysis showed that the area under the curve of the predictive model for the neonatal hypoglycemia of the women with GDM was 0.869, and the model was in good consistency with the real situation. Conclusion: Among these influencing factors of the neonatal hypoglycemia of the pregnant women with GDM, the co

关 键 词：妊娠期糖尿病 新生儿低血糖 危险因素 预测模型 

分 类 号：R722.1[医药卫生—儿科]