妊娠期糖尿病对新生儿并发症及神经行为发育的影响

摘要

Aim:To evaluate the effects of gestational diabetes on neonatal pathological conditions and neurodevelopment.Methods:A prospective and observational study was designed as:210 cases of neo-nates of mothers with gestational diabetes from year 2012 to 2013 were included as GDMgroup,and 210 neonates of healthy mothers were randomly chosen as the control group.Pathological conditions of neo-nates were observed and recorded.Neurological assessment on neonatal behavior was performed on day 7 and Gesell scale of development was performed after 2 months and 6 months,respectively.Results:The incidences of hypoglycemia,polycythemia,preterm birth,large for gestational age,cardiac and cerebral deformity,respiratory distress syndrome,hyperbilirubinemia and infection in GDM group were higher than control group(P <0.05),while the Neonatal Behavioral Neurological Assessment on day 7 and Ge-sell Score on month 2 and 6 month were found decreased in the GDMgroup.Conclusion:Gestational dia-betes may lead to increased risks of pathological complications in neonates and might have long-term effects on neurodevelopment.%目的：观察妊娠期糖尿病对新生儿病理状况及神经行为发育的影响．方法：收集210例妊娠期糖尿病母亲婴儿的临床资料，并从同期健康母亲婴儿按1∶1比例随机抽取210例作为对照组，进行前瞻性观察研究．观察两组新生儿的并发症及病理状况，同时对比两组新生儿出生7日龄的神经行为能力评分和2月龄、6月龄的盖泽尔智能评分．结果：妊娠期糖尿病组新生儿发生低血糖、红细胞增多症、早产、大于胎龄儿、心脑畸形、呼吸窘迫综合征、高胆红素血症、合并感染发生率均高于对照组，有统计学差异（P ＜0.05）；妊娠期糖尿病组新生儿出生后7日龄神经行为能力评分为（36.77±1.33）分，显著低于对照组的（37.46±1.08）分（P ＜0.01）；GDM组婴儿2月龄、6月龄盖泽尔智能评分均显著低于对照组（P ＜0.01，P ＜0.05）．结论：妊娠期糖尿病增加新生儿发生低血糖等病理状况的风险，对新生儿神经行为发育可能有长期不良影响．