糖代謝異常合併妊娠の母児の臨床像

It is known that infants born to mothers with hyperglycemic disorders in pregnancy have a high risk of complications such as macrosomia, neonatal hypoglycemia, and hyperbilirubinemia. Strict treatments such as dietary andinsulin therapy are necessary to prevent these complications.We retrospectively examined 374 infants born to mothers with hyperglycemic disorders in pregnancy whowere treated with dietary and insulin therapy at our hospital over a six-year period from 2014 to 2019. First, thecomplications in the infants included preterm birth in 73 cases (19%), neonatal hypoglycemia in 115 cases (31%),hyperbilirubinemia in 59 cases (16%), and respiratory disorders in 56 cases (15%), as there was a high incidenceof neonatal hypoglycemia. Second, we conducted a univariate analysis to determine the association between theoccurrence of complications (neonatal hypoglycemia, hyperbilirubinemia, and respiratory disorders) in infantsborn to mothers with hyperglycemic disorders and 12 clinical factors. Third, we conducted a multivariate analysisusing each complication as the dependent variable and identified significant factors as independent variables. Wefound that the independent clinical factors associated with neonatal hypoglycemia were mothers’ body mass indexbefore pregnancy, the use of ritodrine hydrochloride during pregnancy, gestational age, and infants with small forgestational age (SGA); those associated with hyperbilirubinemia were gestational age and infants with SGA; andthose associated with respiratory disorders were gestational age.Our study demonstrates that gestational age plays a role in complications observed in infants born to motherswith hyperglycemic disorders in pregnancy who were strictly treated, such as dietary and insulin therapy, ratherthan glycated albumin and glycosylated hemoglobin levels.