Risk Factors Analysis Of Hypoglycemia In Preterm Infants In Our Hospital

Objective: To investigate the risk factors of hypoglycemia in preterm infants and to provide a basis for reducing its occurrence.Methods: The clinical data of 404 preterm infants admitted to the neonatal intensive care unit（NICU）of the First Affiliated Hospital of Dali University from June 2020 to December 2021 were retrospectively analyzed,and 132 preterm infants with hypoglycemia within 7 days after birth were taken as the Observation group,and 132 preterm infants without hypoglycemia within 7 days after birth at the same period were randomly selected as the control group,and the maternal The high risk factors,general condition at birth,and neonatal period diseases were analyzed by univariate and multi-factor regression using SPSS25.0statistical soft.Results:1.among 264 study cases,there were 260 maternal cases with high-risk factors accounting for 98.5% and a total of 4 maternal cases without high-risk factors accounting for 1.5%.Comparative analysis of maternal high-risk factors between the study group and the control group revealed that the differences were statistically significant（P<0.05）for maternal multiple pregnancies（including 47 twins and 1 triplet）,prenatal hormone use ≥2 times,placental abnormalities（including placenta praevia,placental abruption,etc.）,gestational combined diabetes mellitus,gestational combined hypertensive disorders（including gestational combined hypertension,preeclampsia,eclampsia,etc.）;maternal gestational Age≤18 years,maternal pregnancy age ≥35 years,maternal pregnancy ethnicity（Han,ethnic）,pregnancy combined with reproductive system infection（including vaginitis,adnexitis,amniotic cavity infection,etc.）,premature rupture of fetal membranes,intrauterine distress,umbilical cord abnormalities（including umbilical cord twisting,knotting,etc.）,pregnancy combined with thyroid function abnormalities（including hyperthyroidism,hypothyroidism,subclinical hypothyroidism,etc.）,diabetes mellitus combined with pregnancy,other diseases（including anemia,thrombocytopenia,syphilis,AIDS,hypoproteinemia,appendicitis,cholecystitis,etc.）were not statistically significant（P > 0.05）.2.Comparison of the general conditions at birth between the two groups of preterm infants revealed that there were statistically significant differences in weight <2500g,gestational age<32 weeks,and less than gestational age（P<0.05）;there were no statistically significant differences in sex（male and female）,mode of delivery（normal delivery,cesarean delivery）,gestation >1,delivery >1,in vitro fertilization,and fetal anomalies（including ventricular widening,malformation of digestive tract development,pleural effusion,etc.）（P>0.05）.3,Comparison of the disease conditions in the neonatal period between the two groups of preterm infants revealed statistically significant differences in neonatal asphyxia,pathological jaundice,central nervous system diseases（including hypoxic-ischemic encephalopathy and intracranial hemorrhage）,and feeding intolerance（P<0.05）;differences in neonatal respiratory distress syndrome（NRDS）,infections（neonatal pneumonia,neonatal sepsis）,other diseases（including wet lung,congenital heart disease,electrolyte abnormalities,etc.）the differences were not statistically significant（P > 0.05）.4.The incidence of hypoglycemia in this study was 32.7%（132/404）,and the mean blood glucose value and blood glucose recovery time of hypoglycemia occurred in different sex,weight,gestational age and delivery method were different.There were 115 asymptomatic cases（87.1%）and 17 symptomatic cases（12.9%）.The main symptoms included hyporesponsiveness in 4 cases（3.0%）,feeding difficulty in 3 cases（2.3%）,cyanosis in 4cases（3.0%）,limb tremor in 3 cases（2.3%）,and apnea in 3 cases（2.3%）.Conclusion1.Preterm infants with multiple maternal pregnancies,prenatal hormone use ≥2 times,placental abnormalities,combined gestational diabetes or hypertensive disorders are more likely to have hypoglycemia.2.Premature infants weighing <2500g,with gestational age <32 weeks or being younger than gestational age are more likely to have hypoglycemia,and the incidence of hypoglycemia is higher in children with neonatal asphyxia,pathological jaundice,central nervous system diseases（including hypoxic-ischemic encephalopathy and intracranial hemorrhage）,and feeding intolerance.3.the lower the weight of the Observation group,the younger the gestational age the lower the mean glucose value for the occurrence of hypoglycemia and the longer the glucose recovery time.4.Multiple pregnancies,prenatal hormone use ≥2 times,placental abnormalities,gestational combined diabetes,gestational combined hypertensive disorders,low birth weight,gestational age <32 weeks,infants younger than gestational age,neonatal asphyxia,pathological jaundice,central nervous system disorders,and feeding intolerance were all independent risk factors for hypoglycemia in preterm infants.