凝血剂对妊娠糖尿病产妇和新生儿血糖水平的影响。

IF 3 3区 医学 Q1 MEDICINE, GENERAL & INTERNAL
Subeen Hong, Hyun-Joo Seol, JoonHo Lee, Han Sung Hwang, Ji-Hee Sung, Ji Young Kwon, Seung Mi Lee, Won Joon Seong, Soo Ran Choi, Seung Chul Kim, Hee-Sun Kim, Se Jin Lee, Sae-Kyung Choi, Kyung A Lee, Hyun Sun Ko, Hyun Soo Park
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引用次数: 0

摘要

背景:我们调查了使用解痉剂治疗早产的妊娠糖尿病(GDM)妇女中,解痉剂对产妇和新生儿血糖水平的影响:这项多中心、回顾性队列研究纳入了韩国 12 家医院因早产而入院的 GDM 妇女。我们排除了多胎妊娠、畸形、妊娠前或妊娠23周诊断为明显DM的女性,以及接受过多种溶栓药物治疗的女性。根据溶血管药的类型将患者分为阿托西班组、利托君组和硝苯地平组。我们收集了产妇的基线特征、妊娠结局、住院期间产妇的血糖水平以及新生儿的血糖水平。我们比较了三组产妇高血糖和新生儿低血糖的发生频率。我们进行了多变量逻辑回归分析,以评估导致产妇高血糖和新生儿低血糖的因素:结果:共纳入 128 名产妇:分别有44名(34.4%)、51名(39.8%)和33名(25.8%)产妇接受了阿托西班、利托君和硝苯地平治疗。阿托西班和利托君组的平均空腹血糖(FBG)(112.3、109.6 和 89.5 mg/dL,P < 0.001)和餐后 2 小时血糖(PPG2)水平(145.4、148.3 和 116.5 mg/dL,P = 0.004)显著高于硝苯地平组。即使调整了包括产前使用类固醇、入院时胎龄和孕前体重指数在内的协变量,阿托西班和利托君组产妇平均 FBG(≥ 95 mg/dL)和 PPG2(≥ 120 mg/dL)水平偏高的风险仍高于硝苯地平组。与硝苯地平组相比,阿托西班和利托君组发生新生儿低血糖(< 47 mg/dL)的风险也有所增加,几率比分别为 4.58 和 4.67(P < 0.05):结论:与使用硝苯地平的产妇相比,使用阿托西班和利托君溶栓剂治疗早产的GDM产妇发生母体高血糖和新生儿低血糖的风险更高。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Impacts of Tocolytics on Maternal and Neonatal Glucose Levels in Women With Gestational Diabetes Mellitus.

Background: We investigated the impacts of tocolytic agents on maternal and neonatal blood glucose levels in women with gestational diabetes mellitus (GDM) who used tocolytics for preterm labor.

Methods: This multi-center, retrospective cohort study included women with GDM who were admitted for preterm labor from twelve hospitals in South Korea. We excluded women with multiple pregnancies, anomalies, overt DM diagnosed before pregnancy or 23 weeks of gestation, and women who received multiple tocolytics. The patients were divided according to the types of tocolytics; atosiban, ritodrine, and nifedipine group. We collected baseline maternal characteristics, pregnancy outcomes, maternal glucose levels during hospitalization, and neonatal glucose levels. We compared the frequency of maternal hyperglycemia and neonatal hypoglycemia among three groups. A multivariate logistic regression analysis was performed to evaluate the contributing factors to the occurrence of maternal hyperglycemia and neonatal hypoglycemia.

Results: A total of 128 women were included: 44 (34.4%), 51 (39.8%), and 33 (25.8%) women received atosiban, ritodrine, and nifedipine, respectively. Mean fasting blood glucose (FBG) (112.3, 109.6, and 89.5 mg/dL, P < 0.001) and 2-hour postprandial glucose (PPG2) levels (145.4, 148.3, and 116.5 mg/dL, P = 0.004) were significantly higher in atosiban and ritodrine group than those in nifedipine group. Even after adjusting for covariates including antenatal steroid use, gestational age at admission, and pre-pregnancy body mass index, there was an increased risk of high maternal mean FBG (≥ 95 mg/dL) and PPG2 (≥ 120 mg/dL) levels in the atosiban and ritodrine group than in nifedipine group. The atosiban and ritodrine groups are also at increased risk of neonatal hypoglycemia (< 47 mg/dL) compared to the nifedipine group with the odds ratio of 4.58 and 4.67, respectively (P < 0.05).

Conclusion: There is an increased risk of maternal hyperglycemia and neonatal hypoglycemia in women with GDM using atosiban and ritodrine tocolytics for preterm labor compared to those using nifedipine.

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来源期刊
Journal of Korean Medical Science
Journal of Korean Medical Science 医学-医学:内科
CiteScore
7.80
自引率
8.90%
发文量
320
审稿时长
3-6 weeks
期刊介绍: The Journal of Korean Medical Science (JKMS) is an international, peer-reviewed Open Access journal of medicine published weekly in English. The Journal’s publisher is the Korean Academy of Medical Sciences (KAMS), Korean Medical Association (KMA). JKMS aims to publish evidence-based, scientific research articles from various disciplines of the medical sciences. The Journal welcomes articles of general interest to medical researchers especially when they contain original information. Articles on the clinical evaluation of drugs and other therapies, epidemiologic studies of the general population, studies on pathogenic organisms and toxic materials, and the toxicities and adverse effects of therapeutics are welcome.
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