目的: 探索妊娠糖尿病对新生儿心脏的影响及发生新生儿心脏损害的高危因素。方法: 回顾性分析2018年―2021年湖南师范大学第一附属医院582例新生儿的一般资料、孕母资料和心脏超声资料;根据新生儿母亲是否合并妊娠糖尿病（GDM）,分为妊娠糖尿病组（GDM组）和非妊娠糖尿病组（NGDM组）,比较两组间在性别、胎龄、分娩方式、出生体重、发生心脏损害的差异,统计两组发生心脏损害的分布情况;进一步对GDM组的新生儿是否合并心脏损害,将其分为心脏病组和正常组,比较两组间在性别、胎龄、体重、新生儿出生血糖、母亲年龄、妊娠高危并发症、母亲血糖控制方式上的差异,进行单因素分析,并进一步对妊娠糖尿病新生儿发生心脏损害的高危因素,进行多因素的Logistic回归分析。结果: GDM组与NGDM组在性别、胎龄、生产方式上比较差异无统计学意义,GDM组发生心脏损害和异常体重的新生儿明显多于NGDM组,差异具有统计学意义;心脏病组与正常组比较,在性别、母亲年龄、母亲血糖控制方式上无统计学差异,但在胎龄、出生体重、新生儿低血糖和妊娠高危并发症的比较上有明显差异,差异有统计学意义;Logistic回归分析显示,妊娠糖尿病母亲在合并妊娠高危并发症时,是其新生儿合并心脏损害的高危因素（OR=1.796,95% CI：1.045~3.086）。结论: 妊娠糖尿病新生儿更容易发生心脏损害。在妊娠糖尿病新生儿中,早产儿、巨大儿及低体重儿、新生儿低血糖、妊娠高危并发症的新生儿发生心脏损害的风险更大,其中妊娠高危并发症是新生儿心脏损害的危险因素。

Objective To explore the effects of gestational diabetes mellitus on the neonatal heart and the risk factors for developing neonatal cardiac damage. Methods General data, maternal data and cardiac ultrasound data of 582 newborns in the First Affiliated Hospital of Hunan Normal University from 2018 to 2021 were retrospectively analyzed; Depending on whether the mother of the newborn is comorbid with gestational diabetes, were categorized into gestational diabetes group (GDM group) and non-gestational diabetes group (NGDM group), Comparing the differences between the two groups in terms of sex, gestational age, mode of delivery, birth weight, occurrence of cardiac damage, The distribution of the occurrence of cardiac damage in the two groups was counted; Further on whether the neonates in the GDM group had combined heart damage or not, they were categorized into cardiac and normal groups. To compare the differences in gender, gestational age, weight, neonatal birth glucose, mother's age, high-risk pregnancy complications, and mother's glycemic control patterns between the two groups in a univariate analysis, and further performed a multifactorial logistic regression analysis of risk factors for developing cardiac damage in neonates with gestational diabetes mellitus. Results There was no statistically significant difference between the GDM and NGDM groups in terms of sex, gestational age, and mode of delivery. Significantly more newborns developed cardiac damage and abnormal weight in the GDM group than in the NGDM group, and the difference was statistically significant; There were no statistically significant differences between the cardiac group and the normal group in terms of gender, age of the mothers, and mode of glycemic control of the mothers. But there was a statistically significant difference in the comparison of gestational age, birth weight, neonatal hypoglycemia and high-risk complications of pregnancy; Logistic regression analysis showed that mothers with gestational diabetes mellitus, when combined with high-risk complications of pregnancy, were at high risk for combined cardiac damage in their newborns (OR=1.796, 95% CI 1.045-3.086). Conclusions Newborns with gestational diabetes are more likely to develop heart damage. Among neonates with gestational diabetes mellitus, those with preterm, macrosomic and low-birth-weight infants, neonatal hypoglycemia, and high-risk complications of pregnancy are at greater risk for cardiac damage, in which high-risk complications of pregnancy are risk factors for neonatal heart damage.