Effect of Control Level of Glycated Hemoglobin in the Third Trimester of Gestational Diabetes Mellitus on the Risk of Hypoglycemia in Infants Lar-ger than Gestational Age and Neonates
Objective To investigate the effect of control level of glycated hemoglobin A1c(HbA1c)before delivery on the risk of hypoglycemia in infants larger than gestational age(LGA)and neonates in patients with gestational diabetes mel-litus(GDM).Methods The clinical data of 172 GDM patients and their neonates from April 2020 to May 2023 were retro-spectively analyzed.According to the HbA1c value of GDM patients at 1 week before delivery,172 patients were divided into group A(n=60,HbA1c＜6.0%),group B(n=81,HbA1c 6.0%～7.0%),and group C(n=31,HbA1c≥7.0%).Baseline data of GDM patients and neonates in the three groups were collected to compare the occurrence of LGA and neonatal hypoglycemia in the three groups,and the relationship between different HbA1c control levels and LGA and neonatal hypogly-cemia in GDM patients in the third trimester was analyzed by multivariate logistic regression model.Results Fasting blood glucose,newborn birth weight and 1-min Apgar score of the three groups were the lowest in group A,followed by group B and group C(P＜0.05).The initial blood glucose values of the three groups were the highest in group A,followed by group B and group C(P＜0.05).The incidence of LGA and neonatal hypoglycemia in the three groups was the lowest in group A,followed by group B and group C(P＜0.05).Multivariate logistic regression analysis showed that HbA1c levels of 6.0%-7.0%and≥7.0%before delivery were independent risk factors for LGA and neonatal hypoglycemia in GDM patients(P＜0.01).Compared with GDM patients with HbA1c＜6.0%,the risk of LGA was increased by 1.644 and 2.124 times,respectively,and the risk of neonatal hypoglycemia was increased by 1.650 and 2.045 times,respectively.Conclusion HbA1c level of GDM patients in the third trimester of pregnancy is closely related to newborn body mass and blood glucose.Active and effec-tive intervention of HbA1c level of GDM patients before delivery can effectively reduce the risk of LGA and neonatal hypogly-cemia.
Gestational diabetes mellitusLate pregnancyGlycated hemoglobinLarger than gestational ageNeo-natal hypoglycemiaAnalysis of influencing factors
万方数据
维普
