Mulder E J, Visser G H
Department of Obstetrics and Gynaecology, University Hospital Groningen, The Netherlands.
Early Hum Dev. 1991 May;25(2):91-106. doi: 10.1016/0378-3782(91)90188-9.
Early embryonic and fetal growth were followed longitudinally in 23 women with type-1 diabetes to investigate whether there was any evidence of early growth delay and, if so, when it originated and when catch-up growth occurred. Weekly crown-rump length (CRL) measurements were taken between 7 and 14 weeks of gestation; the biparietal diameter (BPD) of the fetal head was measured once every 2-4 weeks from 13 to 30 weeks of gestation. Data were compared to those of a control group and to control data published in the literature. The CRL of the fetuses in the diabetic group was generally shorter than that observed normally. Six out of the 23 (26%) fetuses showed true early growth delay (a size smaller than normal by 6 days or more). Growth delay was present from the first recording onwards and must therefore have occurred before the seventh gestational week. Fetal growth (BPD) was found to be normal at around 20 weeks and there was evidence of accelerated growth of the BPD during the second trimester in fetuses that became macrosomic. Early embryonic growth delay was most profound in the women whose periconceptional quality of glucose control was poor, although the relationship with the HbAlc values was not statistically significant. It is concluded that fetuses of women with type-1 diabetes, as a group, have a significantly different growth pattern than control fetuses throughout the first 30 weeks of pregnancy.
对23名1型糖尿病女性的早期胚胎和胎儿生长情况进行了纵向跟踪研究，以调查是否有早期生长延迟的迹象，若有，则确定其起始时间以及追赶生长发生的时间。在妊娠7至14周期间每周测量头臀长度（CRL）；在妊娠13至30周期间每2至4周测量一次胎儿头部的双顶径（BPD）。将数据与对照组的数据以及文献中发表的对照数据进行比较。糖尿病组胎儿的CRL通常比正常情况下观察到的要短。23名胎儿中有6名（26%）出现了真正的早期生长延迟（尺寸比正常小6天或更多）。从第一次记录起就出现了生长延迟，因此必定发生在妊娠第7周之前。发现胎儿生长（BPD）在约20周时正常，并且在妊娠中期，那些最终成为巨大儿的胎儿的BPD有加速生长的迹象。尽管与糖化血红蛋白（HbAlc）值的关系无统计学意义，但在受孕前后血糖控制质量差的女性中，早期胚胎生长延迟最为明显。得出的结论是，1型糖尿病女性的胎儿作为一个群体，在妊娠的前30周内其生长模式与对照胎儿有显著差异。
