Glucose disappearance in infants of diabetic mothers. III. Relationship of spontaneous glucose disappearance to glucose tolerance,neonatal hypoglycemia and lowest blood glucose

Spontaneous glucose disappearance in the first 90 min of life and glucose disappearance following an intravenous injection of 1 g/kg dextrose were measured in 23 infants of insulin-dependent diabetic mothers. Spontaneous disappearance was log-linear in 12/23 infants, providing for calculation of an endogenous K_t which correlated significantly (P < 0.01) with the exogenous Kt determined after the dextrose injection, r = 0.74.Hypoglycemia <20 mg/dl occurred in 4/23 infants, and was identified during the spontaneous glucose disappearance (3 infants) and/or predicted by an endogenous K_t > 3.0%/min (2 infants). There was also a significant inverse correlation (P < 0.01) of the lowest blood glucose obtained within the first 24 h of life with the endogenous K_t, r = 0.61. There was no correlation of the endogenous or exogenous Kt, lowest blood glucose or hypoglycemia with White's classification of the maternal diabetes, diabetic control during pregnancy, the maternal blood glucose at delivery or the cord blood glucose.These data indicate that determination of spontaneous glucose disappearance within the first 90 min of life is useful in identifying infants of diabetic mothers with hypoglycemia or those who will subsequently develop hypoglycemia.     

Prediction of neonatal hypoglycemia in infants of diabetic mothers by glucose disappearance in the first hour of life

Whole blood glucose determinations were obtained in the first hour of life in 44 infants of diabetic mothers in order to predict the occurrence of subsequent hypoglycemia by means of the calculated glucose disappearance rate. Hypoglycemia (whole blood glucose < 20 mg/dl) occurred in 10 infants with linear glucose disappearance of whom 9 had a glucose disappearance rate ? 3.0% per min (90% sensitivity). Nine of 11 infants with glucose disappearance rates ? 3.0% per min had hypoglycemia (82% specificity). This relatively simple procedure offers an accurate method for prediction of neonatal hypoglycemia due to reactive hyperinsulinemia in infants of diabetic mothers.     

Glucose disappearance in infants of diabetic mothers II. Relationship to lowest neonatal blood glucose and amniotic fluid insulin

Neonatal glucose disappearance (KT) was measured in 26 infants of insulin-dependent diabetic mothers within the first 2 h of life. A significant correlation was found between the KT and the lowest blood glucose (LBG) in the first day of life (r = 0.64, P less than 0.001). None of 21 infants developed a LBG less than 20 mg/dl when the KT was less than 3.0%/min in contrast to 4 of 5 whose KT was greater than 3.0%/min (P less than 0.001). Amniotic fluid (AF) glucose and insulin were determined in 42 samples from 18 of these patients in the third trimester of pregnancy. There was a significant correlation between AF insulin values and the neonatal KT (R = 0.76, P less than 0.001). The correlation was higher when only amniotic fluid values obtained on the day of delivery were considered (n = 17, r = 0.90, P less than 0.001). 1 of 13 infants developed a LBG less than 20 mg/dl when the amniotic fluid insulin was less than 100 mu U/ml on the day of delivery in contrast to 3 of 4 whose AF insulin was greater than 100 mu U/ml (P less than 0.001). No correlation of AF glucose was found with infants' KT or LBG. These data suggest that both neonatal KT and AF insulin are of value for predicting neonatal hypoglycemia and detecting infants who will require treatment for its prevention.     

The usefulness of measuring fructosamine in the cord blood of the newborn infants of diabetic mothers

The aim of our study was to evaluate the usefulness of fructosamine measurement (Fram) in cord blood as an index of glucose metabolism in the last week of pregnancy in infants of diabetic mothers. In newborns and their respective mothers Fram values were surprisingly greater in N than in IDM and IGDM and neonatal and maternal values appeared to be strictly related. While intrauterine growth was associated with metabolic control indexes of 2nd and 3rd trimester gestation. Fram value appeared positively correlated to cord insulin. In conclusion Fram level appears as a good index of glucose metabolic control of the last week of pregnancy and it is associated to cord insulin level and to neonatal hypoglycemia.     

Are the neonatal outcomes similar in large-for-gestational age infants delivered by women with or without gestational diabetes mellitus?

Background

Infants are considered large for gestational age (LGA) if their birth weight is greater than the 90th percentile for gestational age and they have an increased risk for adverse perinatal outcomes. Maternal diabetes is one of the factors affecting birthweight. However there are limited data on the perinatal outcomes of infants of gestational diabetic mothers. The aim of the present study was to compare the neonatal outcomes of LGA infants delivered by women with and without gestational diabetes mellitus.

Methods

This was a retrospective study of LGA infants of ??36 weeks of gestation born at the Gazi University Medical School Hospital during the period of 2006?C2009. Neonatal outcomes included hypoglycemia and polycythemia in the early neonatal period and hospital admissions. The Chi-square and Student??s t test were used for comparing variables.

Results

Seven hundred eligible infant-mother pairs were enrolled in the study. Eighty-seven of them (12.4%) were infants of gestational diabetic mothers and 613 (87.6%) were infants of non-diabetic mothers. The incidence of hypoglycemia at the first hour was higher in infants of diabetic mothers (12.8%) than in infants of non-diabetic mothers (5.3%) (P=0.014). Polycythemia was also more frequently observed in infants of the gestational diabetic mothers (9.3%) than in infants of the non-diabetic mothers (3.0%) (P=0.010). Although overall hospital admission rates were not different between the two groups, infants of diabetic mothers were more likely to be admitted because of resistant hypoglycemia (P=0.045).

Conclusions

The results of this study suggested that LGA infants of mothers with gestational diabetes mellitus were at a greater risk for hypoglycemia and polycythemia in the early neonatal period than LGA infants of nondiabetic mothers.     

胎龄≤32周早产儿低血糖的危险因素分析

目的 探讨胎龄≤32周早产儿出生后发生低血糖的危险因素。方法 回顾性纳入2017年1月至2020年6月入住新生儿重症监护病房的86例胎龄≤32周低血糖早产儿作为低血糖组,随机选取同期住院监测血糖正常的早产儿172例为对照组。采用单因素分析与多因素logistic回归分析筛选早产儿低血糖的危险因素。结果 研究期间早产儿共计515例,其中低血糖86例（16.7%）。低血糖组小于胎龄儿（SGA）、剖宫产出生、孕母高血压、产前使用激素的比例均高于对照组（P < 0.05）,而出生体重及血糖检测前已静脉使用葡萄糖的比例均低于对照组（P < 0.05）。SGA（OR=4.311,95% CI：1.285~14.462）、孕母高血压（OR=2.469,95% CI：1.310~4.652）和产前使用激素（OR=6.337,95% CI：1.430~28.095）为早产儿低血糖的危险因素（P < 0.05）,静脉使用葡萄糖（OR=0.318,95% CI：0.171~0.591）为早产儿低血糖的保护因素（P < 0.05）。结论 SGA、孕母高血压和产前使用激素可增加胎龄≤32周早产儿早期发生低血糖的风险;对胎龄≤32周早产儿,建议生后尽早静脉使用葡萄糖,以减少低血糖的发生。     

Gastrointestinal enhanced insulin release in response to glucose in newborn infants

The purpose of this investigation was to determine whether or not gastrointestinal (GI) enhanced insulin response occurs in newborn infants soon after birth. Glucose infusion by intravenous or orogastric routes was given to infants during the first 4 days of life, aiming at achieving similar plasma glucose concentrations. Their plasma insulin responses were then compared. Thirty term, newborn infants (10 appropriate for gestational age, 8 small for gestational age, 6 large for gestational age, and 6 infants of diabetic mothers) were studied. With intravenous glucose infusions of 8 mg/kg/min or orogastric infusion of 16 mg/kg/min, the plasma glucose concentrations achieved were similar and approximated 110 mg/dl. Plasma insulin responses were greater in infants receiving glucose via the GI route. The finding was in contrast to our previous data, in which no GI enhancement of insulin response was demonstrated. The present data suggest that in the term newborn infant, GI enhanced insulin release occurs only when a threshold of plasma glucose concentration has been exceeded. It appears that the enteroinsular axis is functional in newborns soon after birth.     

Neontal hypoglycaemia in infants of insulin-dependent diabetic mothers.

Neonatal hypoglycaemia (blood glucose smaller than 20 mg/100 ml) occurred in the first 6 hours of life in 25 of 34 infants born to diabetic mothers receiving insulin. Despite severe hypoglycaemia (blood glucose smaller than 10 mg/100 ml) in 17, clinical features of hypoglycaemia were absent in all but 2. Hypoglycaemia was not related either to the level of plasma insulin in cord blood, determined as nonextracted immunoreactive insulin, or to the degree of control of maternal blood glucose during pregnancy. The frequent occurrence of severe neonatal hypoglycaemia in the infants born to diabetic mothers receiving insulin appears to be due rather to failure to maintain basal glucose homoeostasis after birth than to hyperinsulinism.     

妊娠期糖尿病母亲的新生儿出生48小时内血糖的动态变化及低血糖的影响因素

摘要目的：探讨糖尿病母亲婴儿（IDMS）出生后血糖的变化情况,分析IDMS发生低血糖的可能影响因素。方法：回顾性横断面调查,纳入2014年1月1日至12月31日在福建省妇幼保健院（我院)定期产检和分娩、单胎活产的全部妊娠期糖尿病（GDM）产妇,收集产妇和新生儿的一般临床资料、母亲孕产期血糖值和IDMS出生后48 h内各时点的血糖值。血糖值＜2.2 、~2.6 mmol·L-1 为低血糖和临界低血糖。多因素Logistic回归分析IDMS低血糖、临界低血糖的影响因素。结果：共1 083份病志进入本文分析。①GDM产妇年龄(30.2±4.2)岁,(39.1±1.4)孕周,初产妇66.8%,阴道分娩82.4%,孕前BMI＜18.5者4.5%、≥25者9.8%。1 083例IDMS中,早产儿3.8%,男52.5%,Apgar评分均≥8分,出生体重(3 303.7±428.2)g。②IDMS出生0.5 h时平均血糖明显下降,2~48 h呈上升趋势。母亲孕前BMI 18.5~24.9、阴道分娩、足月儿、总产程时间≥7 h、傍晚至夜间分娩、正常体重儿的IDMS出生时和生后某些时点的平均末梢血糖相对较高。③1 083例IDMS中,低血糖7例(0.65%),6例发生在出生时,1例发生在生后48 h;临界低血糖29例(2.68%),26例发生在出生时,生后12、24和48 h各1例。④多因素非条件Logistic回归显示,孕末期静脉血糖水平高是新生儿低血糖、临界低血糖的保护因素。结论：IDMS生后48 h内发生低血糖的时间以出生时最多,但生后48 h都有发生低血糖的可能,应密切监测。GDM孕妇孕末期静脉血糖水平高可能是新生儿低血糖和临界低血糖的保护因素。     

Insulin and Leptin Levels in Appropriate-for-Gestational-Age Infants of Diabetic Mother

Objective

Intensified management of gestational diabetes mellitus can normalize birth weight. However, it is still unknown whether intrauterine exposure to maternal diabetes is a risk factor for changing hormone levels involved in the development of insulin resistance in these infants. We compared insulin and leptin levels in appropriate for gestational age (AGA) infants of diabetic and non diabetic mothers.

Methods

We performed a cross-sectional study in the department of Neonatology of the Hospital of Gynecology-Pediatrics, in Leon, Mexico. We evaluated 182 full term AGA newborns (86 infants of diabetic and 96 of non-diabetic mothers). A venous blood sample was taken from cord blood immediately after the separation of the placenta and glucose, insulin and leptin levels were measured. In all diabetic mothers HbA1c was also evaluated immediately post-partum.

Findings

Leptin, insulin and insulin resistance index were significantly higher in infants of diabetic mothers. Leptin levels were positive correlated with insulin, parents‘ body mass index and age in the entire group. In infants of diabetic mothers only insulin levels showed a significantly correlation, whereas in those of non-diabetic mothers only mothers‘ age was significantly correlated with leptin levels.

Conclusion

AGA infants of diabetic mothers showed higher leptin, insulin levels and insulin resistance index than those of non-diabetic mothers.     

Maternal type 1 and gestational diabetes: postnatal differences in insulin secretion in offspring at preschool age

Background: It is well known that children born to mothers with diabetes in pregnancy are more likely to develop metabolic abnormalities in later life. Most prior studies have not differentiated between offspring of mothers with type 1 diabetes (T1DM) and gestational diabetes (GDM) or lack a control group of non‐exposed offspring. Subjects: Offspring of T1DM (n = 16), GDM (n = 22) and mothers without diabetes (n = 25) born at Oulu University Hospital. Aim: To assess insulin secretion and insulin resistance in the offspring of T1DM and GDM at preschool age in comparison with offspring of non‐diabetic mothers. Methods: Anthropometric measurements and intravenous glucose tolerance testing were performed. First‐phase insulin response (FPIR) and homoeostasis model assessment (HOMA) values were calculated. Pregnancy and birth data were analysed in relation to later metabolic parameters in all three groups using one‐way analysis of variance (anova ) and analysis of covariance (ancova ). Results: At a mean age of 4.9 yr, offspring of T1DM had increased fasting serum insulin concentrations (p = 0.044), FPIR (p = 0.034) and HOMA‐B values (p = 0.008) compared with offspring of GDM or with offspring of healthy controls (statistically non‐significant). The GDM gained least weight during pregnancy, and when adjusted for maternal weight gain during pregnancy, there were no statistically significant differences between study groups. Conclusions: Prenatal exposures to maternal type 1 and gestational diabetes may have different effects on postnatal glucose metabolism in the offspring assessed at a mean age close to 5 yr. Maternal weight gain in pregnancy may affect the postnatal glucose metabolism in the offspring.     

Neonatal hypoglycaemia in infants of diabetic mothers

OBJECTIVE: To determine whether umbilical cord blood glucose correlates with subsequent hypoglycaemia after birth in infants of well-controlled diabetic mothers. METHODOLOGY: Thirty-eight term infants of well-controlled diabetic mothers were enrolled. Five mothers had pre-existing diabetes. Of the 33 gestational diabetic mothers, 16 were managed on insulin and 17 on diet. Maternal blood glucose was maintained between 4 and 8 mmol/L during labour and delivery. Infants' plasma glucose levels were measured from venous cord blood and serially, at less than 30 min, 1 h and 2 h of life by glucose hexokinase method. Blood glucose levels were further monitored by bedside Dextrostix for 24 h. RESULTS: Eighteen (47%) infants developed hypoglycaemia (blood glucose level less than 2 mmol/L) during the first 2 h of life. There was no difference in the cord blood glucose levels between infants with or without hypoglycaemia (3.7 +/- 1.1 vs 4.5 +/- 1.1 mmol/L, respectively). Infants of mothers with diabetes diagnosed prior to 28 weeks gestation were at a higher risk of developing hypoglycaemia (8 of 10 vs 10 of 28, OR 7.2, 95%CI 1.3-40.7). Hypoglycaemic infants were of significantly higher birthweight, and were more likely to be born to Caucasian mothers and by Caesarean section. Raised maternal fructosamine blood level, the need for insulin treatment or the infant's haematocrit were not different between infants with or without hypoglycaemia. CONCLUSIONS: In well-controlled diabetic mothers, the incidence of early hypoglycaemia in infants is still high, particularly in those mothers who had a longer duration of diabetes. Cord blood glucose level did not identify the infants with hypoglycaemia.     

Effect of moderate dosage of chlorpropamide in pregnancy on fetal outcome

The outcome of 19 pregnancies is reviewed in women receiving daily doses of at least 200 mg chlorpropamide for varying degrees of glucose intolerance. 4 required insulin in late pregnancy. In 13 mothers who had chlorpropamide during the first 13 weeks of pregnancy no fetal abnormality occurred. There were 2 intrauterine deaths, 1 neonatal death, 6 babies with birthweights greater than the 90th centile, and 2 with birthweights below the 10th centile. The total dosage taken during pregnancy varied from 5 to 105 g and the duration of administration varied from 3 to 39 weeks. Though the severity of diabetes loosely correlated with the daily chlorpropamide dosage, no constant relation existed between high daily dosage of chlorpropamide and obstetric or neonatal complications. It is concluded that it is more likely to be the poor control of the maternal diabetes in pregnancy than a pharmacological effect of the chlorpropamide on the fetal pancreas which is responsible for the poor results reported. 6 infants had intravenous glucose tolerance tests done within 3 hours of birth and the rate of glucose disposal and insulin response was found to be greater than in infants of untreated mothers with less severe diabetes.     

Follow-up of children of insulin dependent (type I) and gestational diabetic mothers. Growth pattern, glucose tolerance, insulin response, and HLA types

Fifty-three children of insulin dependent (IDM) and 20 children of gestational diabetic mothers (IGDM) representing 80 and 91%, respectively, of all surviving infants of diabetic mothers born between 1969 and 1972 at Sabbatsberg's hospital, Stockholm, participated in the follow-up study. The first follow-up examination was performed when the children had reached approximately 5 years of age and included measurement of height and weight, insulin response to intravenous glucose, and HLA typing. When the children were approximately 11 years old, a search was performed in the national register for type I diabetes in children in order to ascertain the frequency of type I diabetes mellitus in the total series (n = 88). The majority of children had a normal height for age and desirable weight for height. At the first follow-up all children had normal glucose disappearance rates (kt) and the insulin response including the early insulin response to glucose were not different between IDM and IGDM groups. The frequency distribution of HLA antigens (A, B, C) was not different from normal and there was no association between HLA B 8 and/or B 15 and early insulin response or kt values. At the second follow-up, two children of type I diabetic mothers had acquired type I diabetes, both were HLA B 15 positive, had normal kt values at the first follow-up, one with low, one with a high early insulin response. The frequency of type I diabetes in offspring of insulin dependent diabetic mothers was 3%.     

糖尿病母亲婴儿低血糖发生情况及其与脑损伤的关系

目的探讨糖尿病母亲婴儿（IDMS）低血糖的发生情况及其与脑损伤的关系。方法分析86例IDMS低血糖的发生情况、母亲孕期血糖控制与低血糖持续时间的关系。分析其脑损伤发生及严重程度与低血糖持续时间、并其他疾病和症状性低血糖的关系。结果短暂性低血糖75例（87.2%）,反复发作性低血糖11例（12.8%）。母亲孕期血糖反复发作性低血糖发生率控制不满意组为19.4%,满意组为8%。反复发作性低血糖组脑损伤总发生率及重度脑损伤发生率高于短暂性低血糖组,并其他疾病组48.5%和无临床症状组57.4%,均有显著性差异（Pa〈0.05）。结论低血糖的持续时间与母亲妊娠期血糖控制情况及脑损伤发生、严重程度有关;低血糖并其他疾病会加重脑损伤,症状性低血糖时常存在严重脑损伤。     

Follow-up of Children of Insulin Dependent (Type I) and Gestational Diabetic Mothers

ABSTRACT. Fifty-three children of insulin dependent (IDM) and 20 children of gestational diabetic mothers (IGDM) representing 80 and 91 %, respectively, of all surviving infants of diabetic mothers born between 1969 and 1972 at Sabbatsberg's hospital, Stockholm, participated in the follow-up study. The first follow-up examination was performed when the children had reached approximately 5 years of age and included measurement of height and weight, insulin response to intravenous glucose, and HLA typing. When the children were approximately 11 years old, a search was performed in the national register for type I diabetes in children in order to ascertain the frequency of type I diabetes mellitus in the total series ( n =88). The majority of children had a normal height for age and desirable weight for height. At the first follow-up all children had normal glucose disappearance rates ( k _t) and the insulin response including the early insulin response to glucose were not different between IDM and IGDM groups. The frequency distribution of HLA antigens (A, B, C) was not different from normal and there was no association between HLA B 8 and/or B 15 and early insulin respone or k _t values. At the second follow-up, two children of type I diabetic mothers had acquired type I diabetes, both were HLA B 15 positive, had normal k _t values at the first follow-up, one with low, one with a high early insulin response. The frequency of type I diabetes in offspring of insulin dependent diabetic mothers was 3%.     

Asymmetric septal hypertrophy in infants of diabetic mothers. Fetal echocardiography and the impact of maternal diabetic control.

Maternal hyperglycemia may result in fetal hyperinsulinemia and asymmetric septal hypertrophy, macrosomia, and hypoglycemia in infants of diabetic mothers. We monitored glycosylated hemoglobin levels in 61 pregnant diabetic women each trimester as an index of maternal glycemic control and did serial fetal echocardiograms starting at 18 weeks of gestation. At delivery, cord blood C-peptide levels were obtained as an index of fetal hyperinsulinemia. Infants were assessed for hypoglycemia, macrosomia and septal thickening by echocardiography. Nineteen of the 61 infants (31%) had septal hypertrophy, were heavier, and had higher cord blood C-peptide levels and lower serum glucose levels than unaffected infants. Maternal glycosylated hemoglobin levels were higher during the third trimester in mothers of affected infants. Our data support a possible relationship between third-trimester maternal hyperglycemia and neonatal asymmetric septal hypertrophy, macrosomia, and hypoglycemia.     

Metabolic events in infants of diabetic mothers during first 24 hours after birth. I. Changes in plasma glucose, insulin and glucagon

Changes in plasma glucose, nonantibody-bound insulin and glucagon concentrations were studied in 32 newborn infants of diabetic mothers (IDM) during the first 24 hours after birth. Ten infants were born to White class A mothers and 22 to class B-F mothers. The infants were kept fasting during the investigative period and blood was sampled from an umbilical artery catheter. At birth, plasma glucose and glucagon levels were similar in the class A and B-F infants, whereas nonantibody-bound insulin levels were approximately 15-fold higher in the class B-F infants than in the class A infants (p less than 0.001). After birth, plasma glucose fell in all infants, the nadir being reached at two hours (p less than 0.01). Plasma glucose fell by approximately 35% in the class A infants and 63% in the class B-F infants (p less than 0.01). Eight IDM had asymptomatic hypoglycemia (plasma glucose less than 1.9 mmol/l) and four of these infants had glucose levels below 1.7 mmol/l and were withdrawn from further study. In the remaining four hypoglycemic IDM, plasma glucose was about 1.6-fold higher (p less than 0.01) and insulin about 11-fold higher (p less than 0.001) at birth compared to the 24 normoglycemic IDM. The hypoglycemia was attended by unchanged insulin levels in the class A infants, whereas insulin fell in the class B-F infants (p less than 0.01). However, during the whole investigative period, plasma insulin of the class B-F infants was higher than that of the class A infants (p less than 0.01). After birth, plasma glucagon increased slowly in all IDM and peak values were reached after 12 hours in the class A infants (p less than 0.05) and 24 hours in the class B-F infants (p less than 0.01). Only those infants who became hypoglycemic after birth exhibited a significant increment in plasma glucagon from 0.2 hours (p less than 0.05). These results suggest that neonatal hypoglycemia of IDM results from high plasma levels of nonantibody-bound insulin together with a very retarded increment in plasma glucagon levels. The degree of neonatal hypoglycemia and hyperinsulinemia of an individual IDM seems to be positively correlated to the severity of the diabetes of the mother.     

Functional enteroinsular axis in full-term newborn infants

The term "enteroinsular axis" refers to the enhancement of insulin release by hormones secreted from the gut. Gastric inhibitory polypeptide (GIP) is one of the major hormones that mediates this function. The purpose of the present study was to examine whether the enteroinsular axis is functional in newborn infants born at term gestation. Between d 2 and d 4 of life, glucose was infused for 2 h intravenously or orogastrically to 44 fullterm newborn infants, of whom 18 were appropriate for gestational age, nine large for gestational age, eight small for gestational age; nine infants were born to diabetic mothers. Glucose was infused at either 8 mg/kg/min intravenously or 16 mg/kg/min orogastrically to achieve similar plasma glucose concentrations. Plasma insulin and GIP concentrations were compared. Plasma GIP concentration increased significantly with enteral glucose administration in all infants but remained unchanged with parenteral glucose infusion. The responses of plasma insulin and the insulin/glucose ratio were significantly greater in infants receiving enterally than parenterally infused glucose. However, when glucose was infused orogastrically at a lower rate (8 mg/kg/min), plasma GIP concentrations rose, but no enhancement of insulin response was detected, suggesting the importance of the role of circulating glucose in the "enteroinsular axis". The infants of diabetic mothers and the large-for-gestational-age infants had more rapid insulin response to orogastrically administered glucose, but their GIP responses were similar to that of normal infants. These findings suggest that, at term gestation, the newborn infants have a "functional" enteroinsular axis in response to glucose, i.e. the rising plasma GIP contributed in part to the enhanced insulin response to enterally infused glucose.(ABSTRACT TRUNCATED AT 250 WORDS)     

胎龄≤32周早产儿低血糖的危险因素分析

目的 探讨胎龄≤32周早产儿出生后发生低血糖的危险因素。方法 回顾性纳入2017年1月至2020年6月入住新生儿重症监护病房的86例胎龄≤32周低血糖早产儿作为低血糖组,随机选取同期住院监测血糖正常的早产儿172例为对照组。采用单因素分析与多因素logistic回归分析筛选早产儿低血糖的危险因素。结果 研究期间早产儿共计515例,其中低血糖86例（16.7%）。低血糖组小于胎龄儿（SGA）、剖宫产出生、孕母高血压、产前使用激素的比例均高于对照组（P < 0.05）,而出生体重及血糖检测前已静脉使用葡萄糖的比例均低于对照组（P < 0.05）。SGA（OR=4.311,95% CI：1.285~14.462）、孕母高血压（OR=2.469,95% CI：1.310~4.652）和产前使用激素（OR=6.337,95% CI：1.430~28.095）为早产儿低血糖的危险因素（P < 0.05）,静脉使用葡萄糖（OR=0.318,95% CI：0.171~0.591）为早产儿低血糖的保护因素（P < 0.05）。结论 SGA、孕母高血压和产前使用激素可增加胎龄≤32周早产儿早期发生低血糖的风险;对胎龄≤32周早产儿,建议生后尽早静脉使用葡萄糖,以减少低血糖的发生。