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):617-27. doi: 10.1016/j.diabet.2010.11.013.
To evaluate the risks of perinatal complications in infants born to mothers with treated or untreated gestational diabetes mellitus (GDM).
A search of the PubMed database was performed and recommendations from NICE and the French National Authority for Health were consulted.
Untreated moderate or severe GDM increases the risk of foetal and neonatal complications (EL1). The risk of malformations slightly increases in newborns of mothers with GDM compared to the general population (EL2). This risk is probably associated with the presence of undiagnosed type 2 diabetes among patients with GDM (EL2). There is a linear relationship between maternal blood glucose levels and an increased birth weight (EL2). Treatment for GDM reduces the incidence of macrosomia (EL1). Although the risk of cardiomyopathy in cases of GDM cannot be accurately estimated based on the available data, severe clinical forms are rare. The risks of neonatal asphyxia and perinatal mortality are no higher in infants born to women with GDM (EL2). Birth injuries and brachial plexus injuries are rare, and no more likely to occur in cases of untreated GDM. It is difficult to assess the risk of respiratory distress, regardless of its cause. It is not possible to establish a link between GDM and neonatal respiratory problems due to insufficient data. Although the risk of neonatal hypoglycaemia is difficult to determine due to the variable definitions reported in the literature, the incidence of hypoglycaemia requiring intravenous therapy is low (EL1). The risks of hypocalcaemia (EL4) and hyperbilirubinemia (EL1) are similar to the general population.
Serious perinatal complications specifically associated with GDM are rare. Macrosomia has been demonstrated to be the predominant adverse outcome in cases of GDM. It is the main factor linked to reported cases of complications in GDM. Maternal obesity is an additional risk factor for complications, regardless of diabetes status.
评估经治疗和未经治疗的妊娠期糖尿病（GDM）母亲所生婴儿的围产期并发症风险。
检索 PubMed 数据库，并参考 NICE 和法国国家卫生管理局的建议。
未经治疗的中度或重度 GDM 会增加胎儿和新生儿并发症的风险（EL1）。与一般人群相比，GDM 新生儿的畸形风险略有增加（EL2）。这种风险可能与 GDM 患者中未诊断的 2 型糖尿病有关（EL2）。母体血糖水平与出生体重增加呈线性关系（EL2）。GDM 的治疗可降低巨大儿的发生率（EL1）。尽管根据现有数据无法准确估计 GDM 病例中心肌病的风险，但严重的临床形式很少见。GDM 母亲所生婴儿的新生儿窒息和围产儿死亡率并不更高（EL2）。出生损伤和臂丛神经损伤罕见，未经治疗的 GDM 情况下也不太可能发生。由于缺乏数据，难以评估呼吸窘迫的风险，无论其原因如何。由于文献中报道的定义不同，无法在 GDM 和新生儿呼吸问题之间建立联系。尽管由于文献中报道的定义不同，难以确定新生儿低血糖的风险，但需要静脉治疗的低血糖发生率较低（EL1）。低钙血症（EL4）和高胆红素血症（EL1）的风险与一般人群相似。
与 GDM 具体相关的严重围产期并发症很少见。巨大儿已被证明是 GDM 的主要不良结局。它是与 GDM 并发症报告病例相关的主要因素。无论糖尿病状况如何，母体肥胖都是并发症的另一个危险因素。
