Al-Qattan M M, El-Sayed A A F, Al-Zahrani A Y, Al-Mutairi S A, Al-Harbi M S, Al-Mutairi A M, Al-Kahtani F S
Department of Surgery and Department of Obstetrics and Gynecology, King Saud University, Riyadh, Saudi Arabia.
J Hand Surg Eur Vol. 2010 Jun;35(5):362-5. doi: 10.1177/1753193410362645. Epub 2010 Feb 24.
Compared to non-diabetic mothers, diabetic mothers are known to deliver larger babies who are at higher risk for shoulder dystocia and obstetric brachial plexus palsy. The intrapartum forces applied during delivery of larger babies are expected to be higher. Hence, the chances of these babies for good spontaneous recovery are expected to be lower; and this is a generally believed hypothesis. The objective of this retrospective study was to compare obstetric brachial plexus palsy in newborn babies of diabetic and non-diabetic mothers. There were a total of 655 cases of obstetric palsy: 253 cases with diabetic mothers and 402 with non-diabetic mothers. The former were more likely to develop total palsy while the latter were more likely to develop extended Erb's palsy. Newborn babies of diabetic mothers had significantly larger birth weights than those of non-diabetic mothers regardless of the type of palsy. The rate of good spontaneous recovery of the motor power of the limb in the two groups was not significantly different except in total palsy cases for shoulder external rotation and elbow flexion where the recovery was significantly better in the diabetic group. It was concluded that the generally believed hypothesis is not correct if one compares the outcome in the diabetic and non-diabetic groups for each type of palsy.
与非糖尿病母亲相比，糖尿病母亲所分娩的婴儿更大，发生肩难产和产科臂丛神经麻痹的风险更高。预计分娩较大婴儿时产程中的作用力会更大。因此，这些婴儿实现良好自发恢复的可能性预计较低；这是一个普遍认可的假设。这项回顾性研究的目的是比较糖尿病母亲和非糖尿病母亲所生新生儿的产科臂丛神经麻痹情况。产科麻痹共有655例：糖尿病母亲所生者253例，非糖尿病母亲所生者402例。前者更易发生完全性麻痹，而后者更易发生伸展性臂丛神经麻痹。无论麻痹类型如何，糖尿病母亲所生新生儿的出生体重显著高于非糖尿病母亲所生者。两组肢体运动能力的良好自发恢复率无显著差异，但完全性麻痹病例中，糖尿病组在肩部外旋和肘部屈曲方面的恢复明显更好。得出的结论是，如果比较糖尿病组和非糖尿病组每种麻痹类型的结果，普遍认可的假设是不正确的。
