Yogev Yariv, Visser Gerard H A
Perinatal Division, Helen Schneider Hospital for Women, Rabin Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Petah-Tiqva 49100, Israel.
Semin Fetal Neonatal Med. 2009 Apr;14(2):77-84. doi: 10.1016/j.siny.2008.09.002. Epub 2008 Oct 15.
The prevalence of both obesity and gestational diabetes mellitus (GDM) is rising worldwide. The complications of diabetes affecting the mother and fetus are well known. Maternal complications include preterm labor, pre-eclampsia, nephropathy, birth trauma, cesarean section, and postoperative wound complications, among others. Fetal complications include fetal wastage from early pregnancy loss or congenital anomalies, macrosomia, shoulder dystocia, stillbirth, growth restriction, and hypoglycemia, among others. The presence of obesity among diabetic patients compounds these complications. The above-mentioned short-term complications can be mediated by achieving the desired level of glycemic control during pregnancy. However, GDM during pregnancy is associated with increased risk of early obesity, type 2 diabetes during adolescence and the development of metabolic syndrome in early childhood. Additionally, GDM is a marker for the development of overt type 2 diabetes and metabolic syndrome for the mother in the early future.
肥胖症和妊娠期糖尿病(GDM)在全球范围内的患病率都在上升。糖尿病影响母亲和胎儿的并发症是众所周知的。母亲的并发症包括早产、先兆子痫、肾病、分娩创伤、剖宫产以及术后伤口并发症等。胎儿的并发症包括早期妊娠丢失或先天性异常导致的胎儿死亡、巨大儿、肩难产、死产、生长受限和低血糖等。糖尿病患者中肥胖的存在会使这些并发症更加复杂。上述短期并发症可通过孕期达到理想的血糖控制水平来调节。然而,孕期的妊娠期糖尿病与早期肥胖、青春期2型糖尿病以及儿童早期代谢综合征的发生风险增加有关。此外,妊娠期糖尿病是母亲在不久的将来发生显性2型糖尿病和代谢综合征的一个标志。