118例糖尿病孕妇的口服降糖药

Oral hypoglycaemic agents in 118 diabetic pregnancies.

作者信息

Hellmuth E, Damm P, Mølsted-Pedersen L

机构信息

Department of Obstetrics and Gynaecology, The Juliane Marie Centre, Rigshospitalet, University of Copenhagen, Denmark.

出版信息

Diabet Med. 2000 Jul;17(7):507-11. doi: 10.1046/j.1464-5491.2000.00314.x.

DOI:10.1046/j.1464-5491.2000.00314.x

PMID:10972579

Abstract

AIMS

To assess maternal and neonatal complications in pregnancies of diabetic women treated with oral hypoglycaemic agents during pregnancy.

METHODS

A cohort study including all consecutively registered, orally treated pregnant diabetic patients set in a diabetic obstetrical service at a university hospital: 50 women treated with metformin, 68 women treated with sulphonylurea during pregnancy and a reference group of 42 diabetic women treated with insulin during pregnancy.

RESULTS

The prevalence of pre-eclampsia was significantly increased in the group of women treated with metformin compared to women treated with sulphonylurea or insulin (32 vs. 7 vs. 10%, P < 0.001). No difference in neonatal morbidity was observed between the orally treated and insulin-treated group; no cases of severe hypoglycaemia or jaundice were seen in the orally treated groups. However, in the group of women treated with metformin in the third trimester, the perinatal mortality was significantly increased compared to women not treated with metformin (11.6 vs. 1.3%, P < 0.02).

CONCLUSION

Treatment with metformin during pregnancy was associated with increased prevalence of pre-eclampsia and a high perinatal mortality.

摘要

目的

评估孕期接受口服降糖药治疗的糖尿病女性妊娠及新生儿并发症情况。

方法

一项队列研究，纳入在某大学医院糖尿病产科服务中心连续登记的所有接受口服治疗的妊娠糖尿病患者：50名接受二甲双胍治疗的女性、68名孕期接受磺脲类药物治疗的女性以及42名孕期接受胰岛素治疗的糖尿病女性作为参照组。

结果

与接受磺脲类药物或胰岛素治疗的女性相比，接受二甲双胍治疗的女性子痫前期患病率显著升高（32% 对7% 对10%，P<0.001）。口服治疗组与胰岛素治疗组之间未观察到新生儿发病率差异；口服治疗组未出现严重低血糖或黄疸病例。然而，在孕晚期接受二甲双胍治疗的女性组中，围产期死亡率与未接受二甲双胍治疗的女性相比显著升高（11.6% 对1.3%，P<0.02）。