| Objective:The pregnancy, delivery and newborn’s own situation often cause early neonatal blood sugar fluctuations, if not timely corrected, it can bring irreversible damage to the central nervous system for newborns, and some survivors had varying levels disorders of cognitive, motion, language development, or cerebral palsy, epilepsy and so on. The fluctuations of early blood sugar from newborns related to various of factors. To reduce neonatal damage due to excessive blood sugar fluctuations, it is particularly important to stable neonatal blood sugar in a certain range, especially in the first24hours. Currently blood sugar disorder for premature babies, macrosomia newborns reported more change, and pregnancy complications such as diabetes, high blood pressure on neonatal blood sugar also had a lot of reports, but blood sugar monitoring research data in the first24hours for pregnant mothers to normal production of full-term newborns is relatively less and insufficient, the influential factors for the first24hours of blood sugar reported less. The study highlighted the early period of hypoglycemia.The traces of blood glucose has small trauma, repetitive, high credibility, which is suitable for early neonatal blood glucose monitoring. Study on the glucose of the full-term neonates’ first24hours. Discuss the influence on the immediately glucose of newborns in different modes of delivery and reason for cesarean section. Discuss on the predictive value of umbilical cord blood glucose levels for the first24hours of newborns. Discuss the potential influence factors from pregnant women for the immediately glucose levels and the relevant factors from newborns for the immediately glucose levels. The study was trying to sum up experience and accumulate research materials for the first time intervene the fluctuations of neonatal blood sugar and to reduce or avoid the central nervous system injury of neonatal period by blood sugar fluctuations.Methods:1.104cases pregnant women and newborns deliveried by them from Maternity hospital of Provincial Hospital Affiliated to Shandong University from December2011to February2012, during pregnancy37-42w, Single birth, Except high blood pressure during pregnancy, Heart, Lung, Liver, Kidney function are normal, Age21-40.2. Choose Age, BIM of prepregnancy, Weight growth rate during pregnancy, Sugar screening, Admited to fasting glucose, Blood glucose of immediate delivery, six indicators as analysis factors from mothers.3. Choose Gender, Gestational age, Born weight, The situation of amniotic fluid and umbilical cord, four indicators as analysis factors from neonates.4. According to delivery way was divided into three groups:natural birth, selective cesarean delivery, emergency cesarean section, to analysis and compare influence from the different delivery way for the blood glucose level of the first24hours.5. Determination of umbilical cord blood glucose to study the predicting level for the blood glucose level of the first24hours.6. To monitor0.5,2,6,12,24hours traces of blood glucose from neonates; monitor fasting venous blood glucose and immediately delivery from mothers.7. The study set the trace blood sugar2.6mmol/L as the threshold level of hypoglycaemia.Results:1.104cases full-term newborns has47cases that the blood sugar within2hours is not higher than2.6mmol/L, incidence of45.19%(47/104). Hypoglycemia within0.5hour has17cases, incidence of16.35%(17/104), natural birth0case, selective cesarean delivery6cases, incidence of35.29%(6/17), emergency cesarean section11cases, incidence of64.71%(11/17). Hypoglycemia within2hour has34cases, incidence of32.69%(34/104), natural birth7case, incidence of20.59%(7/34), selective cesarean delivery26cases, incidence of76.47%(26/34), emergency cesarean section1cases, incidence of2.94%(1/34). Neonatal hypoglycemia easily occurs at2hour of born naturally and selective cesarean section,0.5hour of emergency cesarean section.2. They were positively correlated between umbilical cord blood glucose and0.5,2hours’blood glucose after birth(r=0.644, r=0.470, P<0.01).The tendency of blood glucose fluctuations from newborns within2hours were (2.2-2.6)mmol/L while the umbilical cord blood glucose were (4.0-4.4)mmol/L.3. Neonatal hypoglycemia risk significantly increased within2hours, with more than30years old (χ2=5.60,χ2=17.33,χ2=33.83), Growth weight over15Kg, the immediate delivery blood glucose below5.0mmol/L.They were negative correlation between Age, Growth weight and the blood glucose levels of0.5,2hours after birth; the blood glucose were positively correlated between immediate delivery and0.5,2hours.4. Neonatal hypoglycemia risk significantly increased within0.5hour（χ2=20.84), with abnormal amniotic fluid and umbilical cord.Conclusions:1. The blood glucose monitoring within the first24hours, especially the2hours of full-term neonatal should be highly valued. The study set the trace blood sugar2.6mmol/L as the threshold level of hypoglycaemia, the incidence of hypoglycemia is more higher.2. Hypoglycemia critical period of full-term neonates was at2hour of born naturally and selective cesarean section, so it is necessary to monitor blood glucose within2hours after birth.3. Hypoglycemia critical period of full-term neonates was at0.5hour of emergency cesarean section, so it is possible to reduce the emergency cesarean section and monitor blood glucose as early as possible.4. The umbilical cord blood level has the very good predictive value for the0.5,2hours blood glucose after birth. It is to wary of hypoglycemia while umbilical cord blood level below4.0mmol/L.5. Age, Growth weight, Blood glucose of immediate delivery are important factors that affect blood glucose. Those newborns whose mother’s Age was more than30years old, Growth weight over15Kg should monitor blood glucose as early as possible, and to pay attention to the below5.0mmol/L immediate delivery blood glucose.4. Abnornal amniotic fluid and umbilical cord affect the blood glucose within0.5hour, so it is necessary to monitor blood glucose after birth. |
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