关键词: 新生儿, 低血糖, 经济负担, 影响因素

Abstract: Background：There are many factors affecting neonatal hypoglycemia, and severe and persistent hypoglycemia can lead to irreversible neurological damage, posing a great burden to families and society. Objective：To explore the influencing factors of economic burden during hospitalization for NICU neonates with hypoglycemia. Design：Cross-sectional study. Methods：Hypoglycemic neonates admitted to the NICU of Children's Hospital of Zhengzhou University from January 1, 2014 to December 31, 2022 were retrospectively included. The gold standard for neonatal hypoglycemia diagnosis is whole blood glucose <2.2 mmol·L-1 or plasma glucose <2.5 mmol·L-1 , and whole blood glucose <2.6 mmol·L-1 was the cut-off value for clinical management. The classification of neonatal hypoglycemia was based on the Expert Consensus on the Clinical Standardized Management of Neonatal Hypoglycemia (2021). The general condition, perinatal condition, clinical examination index, prognosis and hospitalization expenses of the children were collected. Generalized linear regression was used to investigate the factors affecting medical expenses during hospitalization. Main outcome measures：The total hospitalization expenses of neonates with hypoglycemia in NICU. Results：A total of 176 newborns with hypoglycemia were included in this analysis, of which 104 (59.1%) were male and 72 were female. The median age was 4 (2, 9) days. The median total hospitalization cost in RMB was 15,438 (10,670, 23,490) yuan, and the median length of hospital stay was 11.0 (8.0, 16.8) days. Univariate rank-sum test results indicated that symptoms of infection, perinatal brain injury, multiple maternal delivery times, more than four adverse perinatal factors, and improved treatment outcomes all increased the total hospitalization cost, with statistically significant differences. Neonatal blood potassium, C-peptide, abnormal cranial MRI, and hypoglycemic brain injury also increased the total hospitalization cost, with statistically significant differences. Multivariate generalized regression results showed that symptoms of infection, metabolic diseases, multiple maternal delivery times , more than four adverse perinatal factors, and hypoglycemic brain injury were risk factors for the total hospitalization cost. Conclusion：Newborns with symptoms of infection, metabolic diseases, multiple maternal delivery times, more than four adverse perinatal factors, and hypoglycemic brain injury bear a heavier economic burden during hospitalization.

Key words: Neonate, Hypoglycemia, Medical costs, Influent factor