Université Pierre et Marie Curie, Faculté de médecine, Pôle de périnatalité, Service de néonatologie, AP-HP, Hôpital Armand Trousseau, 75571 Paris cedex 12, France.
Diabetes Metab. 2010 Dec;36(6 Pt 2):587-94. doi: 10.1016/j.diabet.2010.11.012.
To evaluate the modalities of neonatal care for cases of treated and untreated gestational diabetes mellitus (GDM).
A search of the PubMed database was performed and recommendations from the National Institute for Health and Clinical Excellence and the French National Authority for Health were consulted.
There were no paediatric indications for birth to take place in a specialised facility, except in cases of severe foetal growth abnormality, major malformations or risk of premature birth. Systematic blood glucose monitoring is recommended for newborns of mothers with insulin-treated GDM, or infants considered large or small for gestational age. Systematic blood glucose monitoring is not recommended for infants of mothers with diet-controlled GDM, or in the absence of growth abnormalities. Newborns should undergo routine neonatal icterus monitoring. Measurement of calcium levels and a complete blood count (CBC) should be carried out when clinically appropriate. Complementary testing for the detection of heart, bone or brain defects should be performed according to clinical signs. The indications for transferring infants of mothers with GDM to a neonatal intensive care unit are the same as for all other newborns.
Newborns can be cared for in general maternity wards, except in cases of premature birth, major malformations or severe foetal growth abnormalities. The management of newborns of mothers with GDM, particularly in the prevention, detection and management of hypoglycaemia, is improved through the existence of a written protocol.
评估治疗和未治疗的妊娠期糖尿病（GDM）病例的新生儿护理方式。
对 PubMed 数据库进行了检索，并咨询了英国国家卫生与临床优化研究所和法国国家卫生管理局的建议。
除了严重胎儿生长异常、重大畸形或早产风险外，患有胰岛素治疗 GDM 的母亲分娩时不需要在专门的医疗机构进行，新生儿也无儿科指征需要在专门的医疗机构进行。建议对胰岛素治疗 GDM 的母亲所生的新生儿，或被认为是胎儿大小与胎龄不符的婴儿进行系统的血糖监测。对于饮食控制 GDM 的母亲所生的婴儿，或在没有生长异常的情况下，不建议进行系统的血糖监测。新生儿应进行常规新生儿黄疸监测。当临床需要时，应测量血钙水平和全血细胞计数（CBC）。根据临床症状，应进行补充检查以检测心脏、骨骼或大脑缺陷。将患有 GDM 的母亲的婴儿转至新生儿重症监护病房的指征与所有其他新生儿相同。
除了早产、重大畸形或严重胎儿生长异常的情况外，新生儿可以在普通产科病房进行护理。通过制定书面方案，可以改善患有 GDM 的母亲所生新生儿的管理，尤其是在预防、发现和处理低血糖方面。
