Diyabetes mellituslu anne bebekleri ve makrozomik bebeklerin neonatal sonuçlarının değerlendirilmesi
Küçük Resim Yok
Tarih
2023
Yazarlar
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Cilt Başlığı
Yayıncı
Trakya Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Diyabetes mellitus görülme sıklığının artışı nedeniyle, beraberinde getirdiği morbiditelerin tanınması, bunun yanı sıra ilişkili sorunlardan olan makrozominin tetikleyicileri ve etkilerinin belirlenerek ortak ya da farklı yönlerinin, tanı, tedavi ve önlemede faydalı olacağı düşüncesinden yola çıkarak yaptığımız bu çalışmada yenidoğan yoğun bakım ünitesinde yatarak ve kadın doğum servisinde anne yanında izlenen makrozomik ve/veya diyabetik anne bebeği olan 534 hastanın kayıtları retrospektif olarak incelendi. Makrozomik-nondiyabetik, makrozomik-diyabetik ve nonmakrozomik-diyabetik olmak üzere ana gruplar ile makrozomi düzeyine göre, 4000-4499 gr, 500-4999 gr, >5000 gr oluşturuldu. Majör anomalisi olan ve çoğul gebelik olan bebekler dışlandı. Hastaların demografik, prenatal, natal ve postnatal özellikleri incelendi. Veriler 534 bebek için analiz edildi ve gruplar arası karşılaştırmalar yapıldı. Makrozomik bebekler arasında diyabetik anne bebeği olanlarda maternal kan şekeri ve HbA1c daha yüksek, kardiyak patolojiler ve polihidroamniyos en sık bu grupta görülmekteydi. Diyabetik anne bebeği olan gruplar arasında RDS en sık makrozomik olmayan diyabetik anne bebeklerinde, YDGT ise makrozomik diyabetik anne bebeklerinde saptandı. İleri canlandırma ihtiyacı diyabetik makrozomik olan bebeklerde daha fazlaydı. Majör morbiditeler olan hipoglisemi, doğum travmaları, sepsis, YDGT, ve RDS'yi, makrozomi, maternal kan şekeri, ponderal indeks, 1. ve 5. dakika Apgar skorları etkilemekteydi. Makrozominin ve çağımızın önemli sağlık sorunlarından biri olan diyabetin, gelişmekte olan fetüs üzerindeki etkilerinin daha iyi anlaşılması, olası risk faktörleri açısından hastaların değerlendirilerek olası mortalite ve morbiditelerden korunması her geçen gün daha fazla önem kazanmaktadır.
Due to the increase in the incidence of diabetes mellitus, recognizing the morbidities it brings with it, as well as determining the triggers and effects of macrosomia, which is one of the related problems, and determining the common or different aspects will be useful in diagnosis, treatment and prevention. The records of 534 patients with babies of macrosomic and/or diabetic mothers who were followed up with their mothers in the ward were retrospectively examined. The main groups: macrosomic-nondiabetic, macrosomic-diabetic and nonmacrosomic-diabetic, and 4000-4499 g, 500-4999 g, >5000 g were created according to the level of macrosomia. Babies with major anomalies and multiple pregnancies were excluded. Demographic, prenatal, natal and postnatal characteristics of the patients were examined. Data were analyzed for 534 infants and comparisons were made between groups. Among macrosomic babies, maternal blood sugar and HbA1c were higher in those born to diabetic mothers, and cardiac pathologies and polyhydramnios were most frequently seen in this group. Among the groups with babies of diabetic mothers, RDS was most frequently detected in babies of non-macrosomic diabetic mothers, and YDGT was detected most frequently in babies of macrosomic diabetic mothers. The need for advanced resuscitation was greater in diabetic macrosomic babies. Major morbidities such as hypoglycemia, birth trauma, sepsis, YDGT, and RDS were affected by macrosomia, maternal blood sugar, ponderal index, and 1st and 5th minute Apgar scores. It is becoming more and more important to better understand the effects of macrosomia and diabetes, one of the important health problems of our age, on the developing fetus, and to protect patients from possible mortality and morbidities by evaluating them in terms of possible risk factors.
Due to the increase in the incidence of diabetes mellitus, recognizing the morbidities it brings with it, as well as determining the triggers and effects of macrosomia, which is one of the related problems, and determining the common or different aspects will be useful in diagnosis, treatment and prevention. The records of 534 patients with babies of macrosomic and/or diabetic mothers who were followed up with their mothers in the ward were retrospectively examined. The main groups: macrosomic-nondiabetic, macrosomic-diabetic and nonmacrosomic-diabetic, and 4000-4499 g, 500-4999 g, >5000 g were created according to the level of macrosomia. Babies with major anomalies and multiple pregnancies were excluded. Demographic, prenatal, natal and postnatal characteristics of the patients were examined. Data were analyzed for 534 infants and comparisons were made between groups. Among macrosomic babies, maternal blood sugar and HbA1c were higher in those born to diabetic mothers, and cardiac pathologies and polyhydramnios were most frequently seen in this group. Among the groups with babies of diabetic mothers, RDS was most frequently detected in babies of non-macrosomic diabetic mothers, and YDGT was detected most frequently in babies of macrosomic diabetic mothers. The need for advanced resuscitation was greater in diabetic macrosomic babies. Major morbidities such as hypoglycemia, birth trauma, sepsis, YDGT, and RDS were affected by macrosomia, maternal blood sugar, ponderal index, and 1st and 5th minute Apgar scores. It is becoming more and more important to better understand the effects of macrosomia and diabetes, one of the important health problems of our age, on the developing fetus, and to protect patients from possible mortality and morbidities by evaluating them in terms of possible risk factors.
Açıklama
Tıpta Uzmanlık
Anahtar Kelimeler
Çocuk Sağlığı ve Hastalıkları, Child Health and Diseases
