妊娠期糖尿病患者按胎龄分层的死产和婴儿死亡风险。
The risk of stillbirth and infant death stratified by gestational age in women with gestational diabetes.
机构信息
Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, San Francisco, CA, USA.
出版信息
Am J Obstet Gynecol. 2012 Apr;206(4):309.e1-7. doi: 10.1016/j.ajog.2012.01.014.
Abstract
OBJECTIVE
We sought to compare the different mortality risks between delivery and expectant management in women with gestational diabetes mellitus (GDM).
STUDY DESIGN
This is a retrospective cohort study that included singleton pregnancies of women diagnosed with GDM delivering at 36-42 weeks' gestational age in California from 1997 through 2006. A composite mortality rate was developed to estimate the risk of expectant management at each gestational age incorporating the stillbirth risk during the week of continuing pregnancy plus the infant mortality risk at the gestational age 1 week hence.
RESULTS
In women with GDM, the risk of expectant management is lower than the risk of delivery at 36 weeks (17.4 vs 19.3/10,000), but at 39 weeks, the risk of expectant management exceeds that of delivery (relative risk, 1.8; 95% confidence interval, 1.2-2.6).
CONCLUSION
In women with GDM, infant mortality rates at 39 weeks are lower than the overall mortality risk of expectant management for 1 week; absolute risks of stillbirth and infant death are low.
摘要
目的
本研究旨在比较患有妊娠期糖尿病（GDM）的女性在分娩和期待管理两种情况下的死亡率差异。
研究设计
本研究为回顾性队列研究，纳入了 1997 年至 2006 年在加利福尼亚州 36-42 孕周分娩的 GDM 单胎妊娠女性。本研究构建了一个复合死亡率，用于估计在每个孕周期待管理的风险，将继续妊娠周内的死胎风险和 1 周后妊娠周龄的婴儿死亡率风险纳入其中。
结果
在患有 GDM 的女性中，36 周时期待管理的风险低于分娩的风险（17.4 比 19.3/10000），但在 39 周时，期待管理的风险超过了分娩的风险（相对风险，1.8；95%置信区间，1.2-2.6）。
结论
在患有 GDM 的女性中，39 周时的婴儿死亡率低于期待管理 1 周的总体死亡率风险；死胎和婴儿死亡的绝对风险较低。
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