妊娠期糖尿病对新生儿肺成熟度及相关肺部疾病的影响-现代医学

妊娠期糖尿病对新生儿肺成熟度及相关肺部疾病的影响

单位：1. 郴州市第一人民医院产科, 湖南郴州 423000;
2. 郴州市第一人民医院新生儿科, 湖南郴州 423000

分类号：R714.25

出版年·卷·期（页码）：2022·50·第四期（397-402）

摘要：

目的：探讨妊娠期糖尿病对新生儿肺成熟度及相关肺部疾病的影响。方法：选取2016年2月至2020年1月本院收治的104例妊娠期糖尿病孕妇作为观察组，另选取同期孕检健康孕妇88例为对照组。随访至分娩，观察两组新生儿肺成熟度与相关肺部疾病发生情况，采用多因素Logistic回归分析法分析妊娠期糖尿病与新生儿肺成熟度及相关肺部疾病发生的关系。结果：观察组新生儿肺成熟占比低于对照组，新生儿肺炎、新生儿呼吸窘迫综合征及支气管肺发育不良发生率均高于对照组，差异有统计学意义(P＜0.05)；观察组新生儿湿肺发生率与对照组比较差异无统计学意义(P＞0.05)；观察组相关肺部疾病总发生率高于对照组，差异有统计学意义(P＜0.05)；经多因素Logistic回归分析发现，妊娠期糖尿病、早产、羊膜腔内未注射地塞米松均是影响新生儿肺成熟度的危险因素(OR值分别为3.364、3.900、2.148，P＜0.05)，妊娠期糖尿病、剖宫产、早产、新生儿体质量＜2 500 g及羊膜腔内未注射地塞米松均是影响新生儿相关肺部疾病发生的危险因素(OR值分别为4.047、2.901、3.626、2.596、1.909，P＜0.05)。结论：妊娠期糖尿病可增加新生儿肺不成熟及相关肺部疾病发生风险。

Objective:To investigate the influences of gestational diabetes mellitus on neonatal pulmonary maturity and related pulmonary diseases. Methods: 104 pregnant women with gestational diabetes mellitus admitted in our hospital from February 2016 to January 2020 were selected as the observation group, another 88 healthy pregnant women at the same period were selected as the control group. All of them were followed up to delivery, and the pulmonary maturity and the incidence of related pulmonary diseases were observed. Multivariate Logistic regression analysis method was used to analyze the relationships between gestational diabetes mellitus and neonatal pulmonary maturity and related pulmonary diseases. Results: The proportion of neonatal pulmonary maturity in the observation group was lower than that in the control group, and the incidence rates of neonatal pneumonia, neonatal respiratory distress syndrome and bronchopulmonary dysplasia in the observation group were higher than those in the control group, and the differences were statistically significant(P<0.05). There was no significant difference in the incidence rate of neonatal wet lung between the observation group and the control group(P>0.05). The total incidence rate of related pulmonary disease in the observation group was higher than that in the control group, and the difference was statistically significant(P<0.05). Multivariate Logistic regression analysis showed that gestational diabetes mellitus, premature delivery and without injecting dexamethasone into amniotic cavity during pregnancy were all risk factors for neonatal pulmonary maturity(OR values were 3.364, 3.900 and 2.148 respectively, P<0.05), and the gestational diabetes mellitus, cesarean section, premature delivery, neonatal weight<2 500 g and without injecting dexamethasone into amniotic cavity during pregnancy were risk factors for related neonatal pulmonary disease(OR values were 4.047, 2.901, 3.626, 2.596 and 1.909 respectively, P<0.05). Conclusion: Gestational diabetes mellitus can increase the risk of neonatal pulmonary immaturity and related pulmonary disease.

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