Yli Branka M, Källén Karin, Stray-Pedersen Babill, Amer-Wåhlin Isis
Department of Obstetrics & Gynaecology, Rikshospitalet-Radiumhospitalet, University of Oslo, Norway.
J Matern Fetal Neonatal Med. 2008 Apr;21(4):231-8. doi: 10.1080/14767050801924431.
The objective of this study was to determine the prevalence and types of ST-segment changes of the fetal electrocardiogram (FECG) during labour in term fetuses born to mothers with diabetes mellitus (DM) or gestational diabetes.
This was a retrospective case-control study involving populations from two multi centre trials: the Swedish Randomized Control Trial and the European Union ST-analysis (EU-STAN) trial. ST-segment changes were assessed in 104/309 cases and 207/468 controls from the Swedish and EU-STAN trials, respectively.
ST depression was present on the FECG in 22.1% of fetuses of mothers with DM compared to 12% of controls OR = 2.6, 95% CI = 1.4-4.7, p = 0.002 after adjusting for trial, birth weight, and nulliparity. ST elevation was present in 47.1% of DM patients and 41.2% of controls (OR = 1.4, 95% CI = 0.9-2.3, p = 0.18).
ST depression on the FECG was significantly more prevalent in the fetuses of mothers with DM, probably not indicating hypoxia but an altered ability of the myocardium to respond to the stress of labour. Further studies into the mechanism of fetal compromise during diabetic labour, are required.
本研究的目的是确定患有糖尿病（DM）或妊娠期糖尿病的母亲所分娩的足月胎儿在分娩期间胎儿心电图（FECG）ST段改变的发生率及类型。
这是一项回顾性病例对照研究，涉及来自两项多中心试验的人群：瑞典随机对照试验和欧盟ST分析（EU - STAN）试验。分别对瑞典试验和EU - STAN试验中的104/309例病例和207/468例对照的ST段改变进行评估。
与12%的对照组相比，患有DM的母亲所分娩胎儿中22.1%的FECG出现ST段压低，在校正试验、出生体重和初产情况后，OR = 2.6，95%CI = 1.4 - 4.7，p = 0.002。47.1%的DM患者和41.2%的对照组出现ST段抬高（OR = 1.4，95%CI = 0.9 - 2.3，p = 0.18）。
患有DM的母亲所分娩胎儿中FECG的ST段压低明显更常见，这可能并不表明缺氧，而是心肌对分娩应激反应能力的改变。需要对糖尿病分娩期间胎儿受损机制进行进一步研究。
