Study On The Correlation Of Hypoglycemia Duration And Severity With Risk Factors,Insulin Level And C-peptide Level In Premature Infants

Objective:Through the analysis of basic clinical history data of neonatal hypoglycemia（NH）in premature infants,pregnancy syndromes,insulin and C-peptide levels,to further explore the relationship between duration and severity of hypoglycemia and its risk factors,providing clinical basis for prediction and theoretical basis for intervention measures.Methods:0ne hundred and twenty premature infants with hypoglycemia（blood glucose value<2.6mmol/L）admitted to our hospital were selected as the study objects,who were treated less than 12 hours after birth from August 2018 to December 2019.Record the clinical case data,Apgar score,maternal pregnancy date,and Insulin and c-peptide levels were measured by blood collection after the infusion was stopped for 2 hours or empty stomach lasts 2-3hours.Guide and standard treatment were given to correct hypoglycemia,and the changes in the blood glucose of the children were dynamically monitored,and record the duration of hypoglycemia until the blood glucose returned to normal.According to two different grouping conditions,one was the duration of hypoglycemia（12h is the threshold）and another was the severity of hypoglycemia（1.1mmol/L is the threshold）divided into:1)the hypoglycemia duration>12h group and the duration<12h group;2)the glucose value≤1.1mmol/L and the glucose value between 1.2mmol/L～2.6 mmol/L.To analyze the relationship between the duration,severity of hypoglycemia and risk factors.SPSS 26.0 statistical package was used for calculating.Enumeration data is expressed in terms of Numbers（%）by chi-square test.The rank data is tested by rank sum test.Measurement data conforming to normal distribution were expressed as mean±standard（（?）±s）by t-test.Multivariate correlation analysis was tested by logistic regression analysis.And P<0.05 was statistically significant.Results:1)The results of gestational diabetes,gestational hypertension,endouterine asphyxia,gestational age and birth weight were statistically significant（P<0.05）;2)Apgar score of 1min in the two groups with different hypoglycemia duration（Z:-1.680 P:0.093 P>0.05）was no statistically significant.3)After Logistic regression analysis:Gestational diabetes（OR:3.155 P:0.017）,gestational hypertension（OR:3.063 P:0.017）,intrauterine distress（OR:3.777 P:0.006）,and gestational age were statistically significant;Among the three groups,gestational age was 28～31⁺⁶compared with 34～36⁺⁶（OR:6.889 P:0.002 P<0.05）.Gestational age at 32～33⁺⁶was compared with that at 34～36⁺⁶（OR:1.520 P:0.439 P>0.05）.4)Insulin level（105.68±32.43）in the duration of hypoglycemia>12h group was higher than that in the duration hypoglycemia<12h group（84.18±25.97）.The c-peptide level（1.01±0.38）nmol/L in the group with hypoglycemia duration of>12h was higher than that in the group with hypoglycemia duration<12h（0.83±0.37）nmol/L.The difference is statistically significant（P<0.05）.5)There were statistically significant in GDM,endouterine asphyxia,premature rupture of membranes（≥12h）,and birth weight between two groups with different duration of hypoglycemia（P<0.05）.6)The asphyxiation rate of the group with blood glucose≤1.1mmol/L in 1 minute was higher than that of the group with blood glucose between1.2-2.6mmol/L.It is statistically significant.P<0.05.7)Gestational diabetes（OR:2.556 P:0.045）and the degree of asphyxia were related to the severity of hypoglycemia.The degree of asphyxiation according to the 1-minute Apgar score.Mild asphyxia（4-7）compared with normal（8-10）（OR:4.118 P:0.004）,severe asphyxia（0-3）compared with normal（8-10）（OR:6.497 P:0.009）（P<0.005）.8)The insulin level（108.27±34.59）in the glucose group≤1.1mmol/L was higher than that in the blood glucose group between 1.2-2.6mmol/L（85.70±26.02）,and the C-peptide level（1.09±0.38）in the blood glucose group≤1.1mmol/L was higher than that in the glucose group between 1.2-2.6mmol/L（0.82±0.38）,P<0.05,and the results were compared between two groups is statistically significant.Conclusion:1.Gestational diabetes mellitus,gestational hypertension,intrauterine distress,and gestational age are risk factors for prolonged hypoglycemia.2.Gestational diabetes mellitus and the degree of asphyxia were the risk factors for aggravating the severity of hypoglycemia.3.The levels of insulin and c-peptide were positively correlated with the duration and severity of hypoglycemia in premature infants.The higher the levels of insulin and c-peptide,the longer the duration and the greater the severity.4.These have gestational diabetes,high blood pressure,gestational age is small,and postnatal asphyxia high-risk premature infants should have their blood sugar tested as early as possible to make an early assessment.Prevent prolonged hypoglycemia and severe hypoglycemia to reduce damage to brain tissue.