Dorman J S, Burke J P, McCarthy B J, Norris J M, Steenkiste A R, Aarons J H, Schmeltz R, Cruickshanks K J
Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, PA 15261, USA.
Diabetes Res Clin Pract. 1999 Jan;43(1):41-7. doi: 10.1016/s0168-8227(98)00123-5.
The objective of this study was to investigate temporal changes in the reported rates of spontaneous abortion associated with Type 1 diabetes. Individuals from the Children's Hospital of Pittsburgh Type 1 Diabetes Registry for 1950-1964 (n=495) completed a self-report reproductive history questionnaire in 1981 that was updated in 1990. Data from both surveys, which proved to be valid and reliable, were utilized for this report. More spontaneous abortions (26.8 vs. 7.7%, P<0.001), stillbirths (4.7 vs. 1.2%, P<0.001) and induced abortions (7.0 vs. 0.9%, P<0.001) were reported for Type 1 diabetic women than for the non-diabetic partners of Type 1 diabetic men. A significant temporal decline in the rates of spontaneous abortion for Type 1 diabetic women was observed (< or = 1969: 26.4%; 1970-1979: 31.0%; 1980-1989: 15.7%; P<0.05). No differences were apparent for the non-diabetic partners of Type 1 diabetic men (< or = 1969: 4.2%; 1970-1979: 9.5%; 1980-1989: 5.7%; P>0.05). Temporal changes in medical care for women with diabetes (i.e. self-monitoring of glycemic control) may have contributed to a recent reduction in spontaneous abortions associated with maternal Type 1 diabetes.
本研究的目的是调查与1型糖尿病相关的自然流产报告率的时间变化。匹兹堡儿童医院1950 - 1964年1型糖尿病登记处的个体(n = 495)于1981年完成了一份自我报告的生殖史问卷,并于1990年进行了更新。来自这两项调查的数据,经证明是有效且可靠的,被用于本报告。与1型糖尿病男性的非糖尿病伴侣相比,1型糖尿病女性报告的自然流产(26.8%对7.7%,P<0.001)、死产(4.7%对1.2%,P<0.001)和人工流产(7.0%对0.9%,P<0.001)更多。观察到1型糖尿病女性的自然流产率有显著的时间下降(≤1969年:26.4%;1970 - 1979年:31.0%;1980 - 1989年:15.7%;P<0.05)。1型糖尿病男性的非糖尿病伴侣没有明显差异(≤1969年:4.2%;1970 - 1979年:9.5%;1980 - 1989年:5.7%;P>0.05)。糖尿病女性医疗护理的时间变化(即血糖控制的自我监测)可能导致了近期与母亲1型糖尿病相关的自然流产减少。