BACKGROUND:Neonatal hypoglycemia is tightly related to adverse neurodevelopmental and brain injury outcomes. METHODS:A total of 195 infants who were born from diabetic mothers with a low blood glucose level (< 2.6 mM) within 0.5 h after birth were enrolled in this prospective cohort study. Of these, 157 infants who had neonatal hypoglycemia (group A) were followed up, and this group was further divided into A1 [blood glucose concentration (BGC) < 2.6 mM at < 2 h after birth], A2 (BGC < 2.6 mM at 2-24 h after birth), and A3 (BGC < 2.6 mM at > 24 h after birth). A total of 144 infants whose mothers had no high risk for gestational diabetes mellitus were followed up as the control group during the same period. The neurodevelopment of the infants was evaluated by the Gesell scoring method. RESULTS:The adaptability in the A2 and A3 subgroups was significantly lower than that in the control group (73.9 ± 6.6 vs. 87.9 ± 11.2; 71.5 ± 8.9 vs. 87.9 ± 11.2, respectively). There were significantly more mothers who used insulin during the perinatal period in A3 than in A1 and A2 (31% vs. 2%; 31% vs. 7.9%, respectively). The mothers of babies in subgroups A2 and A3 gained more weight than those of the control group (15.3 ± 1.9 kg vs. 11.1 ± 2.2 kg; 14.8 ± 2.6 kg vs. 11.1 ± 2.2 kg, respectively). CONCLUSIONS:Long and repeated neonatal hypoglycemia caused poor adaptability. The babies of mothers who used insulin or had a high weight gain during pregnancy were associated with severe or persistent neonatal hypoglycemia.

译文

背景:新生儿低血糖症与不良的神经发育和脑损伤结果密切相关。
方法:该前瞻性队列研究共纳入了195名出生于糖尿病母亲的婴儿,这些母亲在出生后0.5小时内血糖水平低(<2.6 µmM)。其中,对157例新生儿低血糖婴儿进行了随访(A组),并将该组进一步分为A1(出生后<2 h时血糖浓度 24Bh时BGC <2.6 mM)。同期对母亲没有妊娠糖尿病高危风险的144例婴儿进行了随访。婴儿的神经发育通过Gesell评分方法进行评估。
结果:A2和A3亚组的适应性显着低于对照组(分别为73.9±6.6和87.9±11.2; 71.5±8.9和87.9±11.2)。在A3围产期使用胰岛素的母亲明显多于A1和A2(分别为31%和2%; 31%和7.9%)。 A2和A3亚组的母亲的体重增加了,比对照组的体重增加了(分别为15.3±1.9 kg和11.1±2.2 kg; 14.8±2.6 kg和11.1±2.2 kg)。
结论:长期反复的新生儿低血糖症导致适应性较差。在怀孕期间使用胰岛素或体重增加很高的母亲的婴儿与严重或持续的新生儿低血糖症相关。

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