Kitzmiller J L, Gavin L A, Gin G D, Jovanovic-Peterson L, Main E K, Zigrang W D
Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco.
JAMA. 1991 Feb 13;265(6):731-6.
To test the value of intensive management of diabetes before and during early pregnancy, 84 women recruited prior to conception were compared with 110 women who were already pregnant referred at 6 to 30 weeks' gestation. All underwent daily measurement of fasting and postprandial capillary blood glucose levels. Mean blood glucose levels during embryogenesis and organogenesis were within 3.3 to 7.8 mmol/L in 50% of preconception subjects and exceeded 10 mmol/L in 6.5%. One major congenital anomaly occurred in 84 infants (1.2%) of women treated before conception compared with 12 anomalies in 110 infants (10.9%) of mothers in the postconception group. Transient symptomatic hypoglycemia occurred during embryogenesis in 60% of women in the preconception group, with a median frequency of 2.7 episodes per week, but was not associated with excess malformations. We conclude that education and intensive management for glycemic control of diabetic women before and during early pregnancy will prevent excess rates of congenital anomalies in their infants.
为了测试妊娠早期之前及期间糖尿病强化管理的价值，将84名受孕前招募的女性与110名妊娠6至30周转诊时已怀孕的女性进行了比较。所有人都接受了空腹和餐后毛细血管血糖水平的每日测量。在胚胎发生和器官发生期间，50%的受孕前受试者的平均血糖水平在3.3至7.8 mmol/L之间，6.5%的受试者超过10 mmol/L。受孕前接受治疗的女性所生的84名婴儿中有1例（1.2%）出现了一种主要先天性异常，而受孕后组母亲所生的110名婴儿中有12例（10.9%）出现了先天性异常。受孕前组60%的女性在胚胎发生期间出现短暂性症状性低血糖，中位频率为每周2.7次发作，但与畸形增多无关。我们得出结论，对糖尿病女性在妊娠早期之前及期间进行血糖控制的教育和强化管理将预防其婴儿先天性异常的过高发生率。
