Lepercq Jacques, Lin Jay, Hall Gillian C, Wang Edward, Dain Marie-Paule, Riddle Matthew C, Home Philip D
Service de Gynécologie-Obstétrique, Hôpital Cochin-Saint Vincent de Paul, Cedex 14, 75674 Paris, France.
Obstet Gynecol Int. 2012;2012:649070. doi: 10.1155/2012/649070. Epub 2012 May 16.
As glargine, an analog of human insulin, is increasingly used during pregnancy, a meta-analysis assessed its safety in this population. A systematic literature search identified studies of gestational or pregestational diabetes comparing use of insulin glargine with human NPH insulin, with at least 15 women in both arms. Data was extracted for maternal outcomes (weight at delivery, weight gain, 1st/3rd trimester HbA(1c), severe hypoglycemia, gestation/new-onset hypertension, preeclampsia, and cesarean section) and neonatal outcomes (congenital malformations, gestational age at delivery, birth weight, macrosomia, LGA, 5 minute Apgar score >7, NICU admissions, respiratory distress syndrome, neonatal hypoglycemia, and hyperbilirubinemia). Relative risk ratios and weighted mean differences were determined using a random effect model. Eight studies of women using glargine (331) or NPH (371) were analyzed. No significant differences in the efficacy and safety-related outcomes were found between glargine and NPH use during pregnancy.
由于甘精胰岛素（一种人胰岛素类似物）在孕期的使用日益增加，一项荟萃分析评估了其在该人群中的安全性。系统的文献检索确定了关于妊娠期或孕前糖尿病的研究，这些研究比较了甘精胰岛素与人NPH胰岛素的使用情况，两组至少各有15名女性。提取了产妇结局（分娩时体重、体重增加、孕早期/孕晚期糖化血红蛋白、严重低血糖、妊娠期/新发高血压、先兆子痫和剖宫产）和新生儿结局（先天性畸形、分娩时孕周、出生体重、巨大儿、大于胎龄儿、5分钟阿氏评分>7、新生儿重症监护病房入院、呼吸窘迫综合征、新生儿低血糖和高胆红素血症）的数据。使用随机效应模型确定相对风险比和加权平均差。分析了八项关于使用甘精胰岛素（331例）或NPH（371例）的女性的研究。在孕期使用甘精胰岛素和NPH之间，未发现疗效和安全性相关结局有显著差异。
