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| Clinical Value of Serum Glycosylated Hemoglobin and Albumin Levels in Predicting the Risk of Infection After Cesarean Section in Puerperae with Gestational Diabetes Mellitus |
| PAN Juerong, WEI Hui, CHEN Ying, et al |
| Liuzhou People's Hospital, Guangxi Liuzhou 545006, China |
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Abstract Objective: To explore the risk factors of infection after cesarean section in puerperae with gestational diabetes mellitus (GDM) and the predictive value of serum glycosylated hemoglobin (HbA1c) and albumin (Alb) on postoperative infection. Methods: The clinical data of 110 puerperae with GDM admitted from September 2017 to September 2020 were retrospectively analyzed. The levels of serum biochemical indicators such as fasting plasma glucose (FPG), HbA1c, hemoglobin (Hb), glycated albumin (GA), Alb and total cholesterol (TC) were detected among all puerperae in the morning before cesarean section. The occurrence of infection after cesarean section was counted, and the factors of general maternal data, surgical data and pregnancy-related complications that might affect postoperative infection were collected among all puerperae. Univariate analysis and multivariate logistic regression analysis were used to explore the risk factors affecting postoperative infection, and receiver operating characteristic (ROC) curve was plotted to explore the predictive value of serum indicators on postoperative infection. Results: The incidence rate of postoperative infection was 26.36% (29/110) among puerperae with GDM after cesarean section, including incision infection of 10.00% (11/110), urinary tract infection of 11.82% (13/110) and lung infection of 4.55% (5/110). There were statistically significant differences in the surgical incision length, intraoperative blood loss, presence or absence of prophylactic use of antibiotics, presence or absence of genital tract inflammation, amniotic fluid pollution and premature rupture of membranes and levels of serum FPG, HbA1c, GA and Alb between infection group and non-infection group of GDM puerperae after cesarean section (P<0.05). Multivariate logistic regression analysis showed that prophylactic use of antibiotics was a protective factor for infection after cesarean section in GDM puerperae (P<0.05), and the genital tract inflammation, amniotic fluid pollution, premature rupture of membranes, HbA1c>6.5% and Alb<40g/ L were independent risk factors for postoperative infection (P<0.05). The areas under the ROC curves of serum HbA1c, Alb and the combination of the two in predicting infection after cesarean section in GDM puerperae were 0.733, 0.700 and 0.797 respectively (P<0.05). Conclusion: There is a certain incidence rate of infection after cesarean section in GDM puerperae. Prophylactic use of antibiotics is the protective factor, and genital tract inflammation, amniotic fluid pollution, premature rupture of membranes and high serum HbA1c and low Alb levels are risk factors. The combined detection of serum HbA1c and Alb before surgery has a certain predictive value on postoperative infection.
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2021, Vol. 27 
