比沙的孕产妇糖尿病与新生儿结局:回顾性队列研究

Abdullah Alshomrany, Elhadi Miskeen, Jaber A. Alfaifi, Hassan Alshamrani, Abdulmohsen Alshahrani
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摘要

背景:产妇糖尿病(MDM)与新生儿不良预后的风险增加有关。然而,在沙特阿拉伯的一个城市比沙(Bisha),MDM 对新生儿预后的影响还没有很好的记录。本研究旨在调查 MDM 对沙特阿拉伯比沙妇幼医院(MCH)新生儿预后的影响。研究方法对 2020 年 10 月 5 日至 2022 年 11 月 5 日期间在沙特阿拉伯比沙妇幼医院(MCH)确诊的 181 名糖尿病孕妇及其新生儿进行了回顾性队列研究。主要结果是新生儿不良结局的综合,包括死产、新生儿死亡、巨大儿、早产、呼吸窘迫综合征、低血糖和先天性畸形。采用逻辑回归分析调整潜在的混杂因素。结果样本总数为 181 例。患者平均年龄为 34 岁(SD = 6.45)。大多数患者被确诊为 GDM(147 例,占 81.2%),GDM 前期(34 例,占 18.8%)。与母亲未患甲胎蛋白血症的新生儿相比,母亲患甲胎蛋白血症的新生儿发生不良新生儿结局的风险更高(调整后的几率比 [aOR] = 1.46,95% 置信区间 [CI]:1.25-1.70)。患有 MDM 的母亲所生的新生儿发生巨大儿(aOR = 1.74,95% CI:1.38-2.19)、低体重儿(aOR = 1.32,95% CI:1.06-1.66)和 RDS(aOR = 1.57,95% CI:1.28-1.93)的风险明显更高。DM类型与以下新生儿结局的相关性具有统计学意义:低血糖(P值=0.017)、巨大儿(P值=0.050)和新生儿死亡(P值=0.017)。结论在比沙,MDM 与新生儿不良结局的风险增加有关。早期识别和处理 MDM 可改善新生儿预后,降低新生儿发病率和死亡率。
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Maternal Diabetes Mellitus and Neonatal Outcomes in Bisha: A Retrospective Cohort Study
Background: Maternal diabetes mellitus (MDM) is associated with increased risks for adverse neonatal outcomes. However, the impact of MDM on neonatal outcomes in Bisha, a city in Saudi Arabia, is not well documented. This study aims to investigate the impact of MDM on neonatal outcomes in the Maternity and Children’s Hospital (MCH), Bisha, Saudi Arabia. Methods: A retrospective cohort study was conducted on 181 pregnant women with diabetes and their neonates who were diagnosed at the Maternity and Children’s Hospital (MCH), Bisha, Saudi Arabia, between 5 October 2020 and 5 November 2022. The primary outcome was a composite of adverse neonatal outcomes, including stillbirth, neonatal death, macrosomia, preterm birth, respiratory distress syndrome, hypoglycemia, and congenital anomalies. Logistic regression analyses were used to adjust for potential confounders. Results: The total sample size was 181. The average age of patients was 34 years (SD = 6.45). The majority of the patients were diagnosed with GDM, 147 (81.2%), and pre-GDM, 34 (18.8%). Neonates born to mothers with MDM had a higher risk of adverse neonatal outcomes compared to those born to mothers without MDM (adjusted odds ratio [aOR] = 1.46, 95% confidence interval [CI]: 1.25–1.70). The risks of macrosomia (aOR = 1.74, 95% CI: 1.38–2.19), LBW (aOR = 1.32, 95% CI: 1.06–1.66), and RDS (aOR = 1.57, 95% CI: 1.28–1.93) were significantly higher among neonates born to mothers with MDM. The types of DM were statistically significant in terms of their correlation with the following neonatal outcomes: hypoglycemia (p-value = 0.017), macrosomia (p-value = 0.050), and neonatal death (p-value = 0.017). Conclusions: MDM is associated with an increased risk of adverse neonatal outcomes in Bisha. The early identification and management of MDM may improve neonatal outcomes and reduce the burden of neonatal morbidity and mortality in this population.
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