| Objective: To analyze the risk factors and clinical characteristics of neonatal hypoglycemia(NH),and construct a neonatal hypoglycemia risk prediction model to provide a reference basis for early detection of hypoglycemia in neonates and clinical formulation of reasonable preventivemeasures.Method: A total of 424 neonates admitted to the hospital from January 2019 to December2021 were selected as the research objects,including 212 neonates with hypoglycemia as the hypoglycemic group,and 212 neonates with normal blood glucose detection during the same period were selected as the non-hypoglycemic group by systematic sampling method.According to the diagnostic criteria of severe hypoglycemia,the hypoglycemia group was divided into severe hypoglycemia group and non-severe hypoglycemia group(referred to as severe group and non-severe group).Relevant information and clinical characteristics of the children and the pregnant mothers in each group were compared and analyzed,including the gestational age,gender,ethnicity,birth weight,delivery method,neonatal complications,mother pregnancy complications and abnormal factors related to the perinatal factors of comparison.Logistic regression analysis was used toconstruct a prediction model for neonatal hypoglycemia risk,and draw a nomogram,and ROC curves were used to evaluate the prediction effect,all of whichwerestatistically significantat P<0.05.Results:1.The main clinical manifestations of neonatal hypoglycemia were irritability in 39 cases(18.40%),poor response and drowsiness in 22 cases(10.38%),cyanosis and apnea in 12 cases(5.66%),trembling of limbs in 10 cases(4.72%),convulsions in 6 cases(2.83%),and asymptomaticin123 cases(58.02%).2.Analysisofrisk factors associated withneonatal hypoglycemia:(1)Results of univariate analysis: gestational age and birth weight of newborns in the hypoglycemic group were lower than those in the control group,and the difference was statistically significant(P<0.05);the proportions of preterm infants,low birth weight infants,SGA,electrolyte disorders,twin births,advanced maternal age,GDM,and PIH in the hypoglycemic group were higher than those in the non-hypoglycemic group,and the difference was statistically significant(P<0.05);there were no statistically significant differences in the composition of the two groups in terms of ethnicity,gender,term delivery,macrosomia,LGA,neonatal asphyxia,neonatal hyperbilirubinemia,NRDS,HIE,history of maternal miscarriage,history offetal preservation andprematurerupture ofmembranes(P>0.05).(2)Logistic regression model analysis showed that gestational age(OR=0.681),birth weight(OR=1.897),twin births(OR=3.888),SGA(OR=3.158),GDM(OR=2.374),and PIH(OR=3.361)were independent risk factors for the occurrence of neonatal hypoglycemia(P<0.05).(3)Results of ROC curve analysis: AUC: 0.792,P<0.001,95% CI: 0.751-0.834,sensitivity of84.0%,specificityof59.4%.3.Analysis of risk factors for neonatal severe hypoglycemia: the proportion of neonatal asphyxiaand electrolytedisturbancewas higher intheseveregroup than inthe non-severegroup,which was statistically significant(P<0.05).Among them,4 cases of hypoglycemic brain injury occurred in the critically ill group.Comparing the gestational age,birth weight,prematurity,low birth weightinfants,SGA,LGA,advanced maternal ageand twin births between thetwogroups,therewereno statisticaldifferences(P>0.05).Conclusion:1.Gestational age and birth weight of newborns are related to the occurrence of hypoglycemia.Twin fetuses,SGA,GDM and PIH are independent risk factors for the occurrence of neonatal hypoglycemia,and glucose monitoring procedures should be established forearly diagnosisand treatment.2.Neonatal asphyxia and electrolyte disorders are risk factors for the occurrence of severe hypoglycemia in neonates,and clinical needs to closely monitor the changes of neonatal blood glucoseandtake targeted interventions toimproveneonatal blood glucosestatus.3.The neonatal hypoglycemia risk model has a certain predictive value for the occurrence ofneonatalhypoglycemia. |
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