根据产妇治疗高血压产妇新生儿血糖的变化。

Revista do Hospital das Clinicas Pub Date : 2004-10-01 Epub Date: 2004-10-29 DOI:10.1590/s0041-87812004000500004
Silvana Darcie, Cléa R Leone, Valdenise M L T Calil, Elizete P Prescinotti, Soubhi Kahhale, Marcelo Zugaib
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引用次数: 9

摘要

目的:探讨高血压母亲新生儿血糖水平随母亲治疗的变化。方法:前瞻性随机研究,纳入93例新生儿,母亲使用isradipine (n = 39)、atenolol (n = 40)或低钠饮食(对照组- n=14)。测定出生时(母亲和新生儿)和出生后第1、3、6、12、24小时(新生儿用试纸法)血糖。分析各组血糖变化(Friedman试验)。比较各组的血糖(Kruskall-Wallis检验),并建立线性回归模型进行分析(自变量=产妇血糖;因变量=脐带,第3和第6小时血糖)。结果:三组患者在各项指标上的平均血糖水平差异均无统计学意义。isradipine组孕妇和脐带血血糖存在相关性(r = 0.61;结论:三种治疗方法对新生儿血糖的影响相似。相关性分析表明,isradipine仅在出生后对新生儿血糖有影响(仅在脐带血中有相关性),而atenolol可以更早起作用(在任何时刻都没有相关性)。结果还指出,无论是否接受过降压药治疗,高血压母亲的新生儿从产后第一个小时起就需要控制血糖。
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Glycemia in newborns of hypertensive mothers according to maternal treatment.

Purpose: To evaluate the evolution of glycemic levels in newborns of hypertensive mothers according to maternal treatment.

Methods: Prospective randomized study, including 93 newborns of mothers treated with isradipine (n = 39), atenolol (n = 40), or low sodium diet (control group - n=14). Glycemia was determined at birth (mother and newborn by the oxidase glucose method) and in the 1st, 3rd, 6th, 12th, and 24th hours after birth (newborn by a test strip method). The evolution of glycemia was analyzed in each group (Friedman test). The groups were compared regarding glycemia (Kruskall-Wallis test), and linear regression models were constructed for the analyses (independent variable = maternal glycemia; dependent variables = umbilical cord, 3rd, and 6th hour glycemia).

Results: There were no statistically significant differences among the mean blood glucose levels of the 3 groups in any of the assessments. There was a correlation between maternal and umbilical cord blood glucose in the isradipine (r = 0.61; P <.05) and control (r = 0.84; P <.05) groups. Regarding glycemia levels of the mothers and newborns in the third and sixth hours postpartum, this correlation was present only in the control group (maternal x third hour: r = 0.65; P <.05; maternal x sixth hour: r = 0.68; P <.05). There were no correlations in the atenolol group. Hypoglycemia was detected in 51.3% of the isradipine group, 60% of the atenolol group, and 35.7% of the control group, and it was more frequent in the first hour postpartum in all groups.

Conclusions: The results suggest a similar effect of the 3 types of treatment upon newborn glycemia. The correlation analysis suggests that isradipine could have effects upon newborn glycemia only after birth (correlation only in umbilical cord blood), whereas atenolol could act earlier (there was no correlation at any moment). The results also point to the need for glycemic control from the first hour postpartum of newborns of hypertensive mothers whether they have or have not undergone treatment with antihypertensive drugs.

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