Gul'kevich Iu V, Min'kovich B M
Arkh Patol. 1975;37(8):3-13.
The present article gives an analysis of available literature and the authors' own findings. Perinatal mortality of progeny of mothers suffering from diabetes mellitus may be caused both by embryopathy and antenatal fetopathy. The authors did not observe diabetic gameto- and blastopathies and no indications to their existance was found in literature, although some investigators admit the possibility of genetic implication in the pathology of progeny of parents with diabetes mellitus. In the progeny of mothers suffering from diabetes mellitus among congenital malformations which allow further intrauterine development and even extrauterine life, according to literature data most often there were observed malformations of the skeleton (37%), cardiovascular system malformations (24%) and those of the nervous system (14%). In all observations of the authors there were found congenital malformations of the bone system not infrequently in combination with other congenital defects. The main features of diabetic fetopathy appear in the last third of pregnancy, and therefore it may be considered as late antenatal fetopathy. The term "diabetic children" applied by some authors to children with diabetic fetopathy should be avoided since it may be erroneously understood as diabetes mellitus. In the majority of cases quite different mechanisms underlie these conditions: hypofunction of the islet apparatus of the pancreas in diabetes mellitus, and its hypofunction in diabetic fetopathy. Diagnosis of diabetic feto- and embryopathies is always based on both clinical and morphological data.
本文对现有文献及作者自身的研究结果进行了分析。患有糖尿病的母亲所生后代的围产期死亡率可能由胚胎病和产前胎儿病共同导致。作者未观察到糖尿病配子病和胚细胞病,且文献中也未发现其存在的迹象,尽管一些研究者承认糖尿病患者后代的病理情况可能存在遗传因素。根据文献数据,在患有糖尿病的母亲所生后代中,那些能够在子宫内进一步发育甚至存活至宫外的先天性畸形中,最常观察到的是骨骼畸形(37%)、心血管系统畸形(24%)和神经系统畸形(14%)。在作者的所有观察中,经常发现骨系统先天性畸形,且常与其他先天性缺陷合并出现。糖尿病胎儿病的主要特征出现在妊娠晚期,因此可将其视为晚期产前胎儿病。一些作者将患有糖尿病胎儿病的儿童称为“糖尿病儿童”,这种说法应避免,因为它可能会被错误地理解为糖尿病。在大多数情况下,这些病症的发病机制截然不同:糖尿病是胰腺胰岛功能减退,而糖尿病胎儿病是胰岛功能减退。糖尿病胎儿病和胚胎病的诊断始终基于临床和形态学数据。