Department of Reproductive Biology, Case Western Reserve University, MetroHealth Medical Center, Cleveland, OH 44109, USA.
Semin Perinatol. 2011 Oct;35(5):297-301. doi: 10.1053/j.semperi.2011.05.003.
The number of pregnant women who have type 2 diabetes and the number found to have gestational diabetes are progressively increasing. In the future, as many as 20% of pregnant women may be diagnosed with diabetes. Although there is consensus regarding many issues in the treatment of pregnant women with diabetes, there are few evidenced-based studies upon which to base the timing of delivery. There must be a balance between increased neonatal morbidity of late preterm and early-term delivery and fetal mortality. Potential adverse outcomes associated with late preterm and early-term delivery include respiratory problems as well as other metabolic dysfunctions characteristic of the preterm infant of a mother with diabetes. Delivery at term increases the risk of fetal demise, fetal overgrowth, and birth injury. Even among diabetic women who practice good glycemic control, the risk of intrauterine fetal demise in third trimester appears greater than that of neonatal death. Additional prospective data are urgently needed to better understand the short and long-term risks and benefits of the timing of delivery in this very common obstetrical dilemma.
患 2 型糖尿病的孕妇数量和被诊断为妊娠期糖尿病的孕妇数量都在逐渐增加。未来，多达 20%的孕妇可能会被诊断患有糖尿病。尽管在治疗患有糖尿病的孕妇方面存在许多共识，但很少有基于证据的研究可以为分娩时机提供依据。必须在晚期早产儿和早期足月分娩的新生儿发病率增加与胎儿死亡率之间取得平衡。与晚期早产儿和早期足月分娩相关的潜在不良结局包括呼吸问题以及其他与糖尿病母亲的早产儿相关的代谢功能障碍。足月分娩会增加胎儿死亡、胎儿过度生长和分娩损伤的风险。即使在血糖控制良好的糖尿病妇女中，妊娠晚期胎儿宫内死亡的风险似乎也高于新生儿死亡的风险。迫切需要更多的前瞻性数据，以更好地了解在这种常见的产科困境中分娩时机的短期和长期风险和益处。
