Teramo Kari, Klemetti Miira, Tikkanen Minna, Nuutila Mika
HYKS Naistenklinikka.
Duodecim. 2013;129(3):228-34.
Perinatal mortality has not decreased in type 1 diabetic pregnancies during the last 30 years. Fetal deaths are five times and neonatal deaths three times higher compared with the general population. Chronic intrauterine hypoxia caused by maternal diabetes is the most likely cause of stillbirths during the last weeks of pregnancy. Both fetal hyperglycemia and hyperinsulinemia can independently cause fetal chronic hypoxia by increasing fetal oxygen consumption. Fetal chronic hypoxia can be detected antenatally by measuring amniotic fluid erythropoietin concentration. Prepregnancy visits for advice and glycemic control should be increased among diabetic women. Furthermore, pregnancy surveillance should be enhanced and therapeutic strategies changed in order to improve perinatal outcome among diabetic pregnancies.
在过去30年中，1型糖尿病孕妇的围产期死亡率并未下降。与普通人群相比，胎儿死亡是其5倍，新生儿死亡是其3倍。母体糖尿病导致的慢性子宫内缺氧是妊娠最后几周死产的最可能原因。胎儿高血糖和高胰岛素血症均可通过增加胎儿氧耗独立导致胎儿慢性缺氧。通过测量羊水促红细胞生成素浓度可在产前检测出胎儿慢性缺氧。糖尿病女性应增加孕前咨询和血糖控制的就诊次数。此外，应加强孕期监测并改变治疗策略，以改善糖尿病妊娠的围产期结局。
