Department of Psychiatry and Neurobehavioral Sciences, Division of Behavioral Health and Technology, University of Virginia School of Medicine, 310 Old Ivy Way, Suite 102, Charlottesville, VA, 22903, USA,
Curr Diab Rep. 2013 Dec;13(6):869-76. doi: 10.1007/s11892-013-0417-5.
Ineffective management of blood glucose levels during preconception and pregnancy has been associated with severe maternal and fetal complications in women with pre-existing diabetes. Studies have demonstrated that preconception counseling and pre-pregnancy care can dramatically reduce these risks. However, pregnancy-related outcomes in women with diabetes continue to be less than ideal. This review highlights and discusses a variety of patient, provider, and organizational factors that can contribute to these suboptimal outcomes. Based on the findings of studies reviewed and authors' clinical and research experiences, recommendations have been proposed focusing on various aspects of care provided, including improved accessibility to effective preconception and pregnancy-related care and better organized clinic consultations that are sensitive to women's diabetes and pregnancy needs.
在患有糖尿病的女性中，受孕前和妊娠期间血糖控制不佳与严重的母婴并发症有关。研究表明，受孕前咨询和孕前护理可以显著降低这些风险。然而，糖尿病女性的妊娠相关结局仍然不尽如人意。本综述重点讨论并强调了多种可能导致这种不理想结局的患者、医护人员和组织因素。基于所审查研究的结果以及作者的临床和研究经验，提出了各种建议，重点关注提供的护理的各个方面，包括改善获得有效受孕前和妊娠相关护理的机会，并更好地组织对女性糖尿病和妊娠需求敏感的诊所咨询。
