Jaffiol C, Baccara M T, Renard E, Apostol D J, Lefebvre P, Boulot P, Daures J P, Bringer J
Service d'Endocrinologie, CHU de Montpellier.
Bull Acad Natl Med. 2000;184(5):995-1007; discussion 1007-8.
Fetal mortality and morbidity remain dramatically increased in diabetic women. To evaluate the benefit of a preconceptional education combined with a good metabolic control, we compared the outcome of pregnancy in 2 groups of type I diabetic women: group A (n = 21) planned before conception versus group B (n = 40) not planned. Both groups were similar related to the type and duration of diabetes, its complications, age, body mass index and different factors of risk. In group A, HbA1C levels were < or = 3 SD of the normal mean of non diabetic values before conception and during the pregnancy course and > or = 3 SD in group B. We observed a significant reduction (p < 0.05) of the main adverse events regarding fetus outcome (fetal, perinatal and neonatal mortality, malformations) and obstetrical complications in the planned group. These data lead to the need of an extensive policy of early planification of pregnancy in diabetic women.
糖尿病女性的胎儿死亡率和发病率仍显著增加。为评估孕前教育结合良好代谢控制的益处，我们比较了两组I型糖尿病女性的妊娠结局：A组（n = 21）在孕前进行了规划，B组（n = 40）未进行规划。两组在糖尿病类型、病程、并发症、年龄、体重指数及不同风险因素方面相似。A组在孕前及孕期过程中糖化血红蛋白（HbA1C）水平≤非糖尿病值正常均值的3个标准差，B组则≥3个标准差。我们观察到，在规划组中，与胎儿结局（胎儿、围产期和新生儿死亡率、畸形）及产科并发症相关的主要不良事件显著减少（p < 0.05）。这些数据表明，需要对糖尿病女性实施广泛的早期妊娠规划政策。
