Hiersch Liran, Yogev Yariv
Helen Schneider Hospital for Women, Rabin Medical Center, Petach Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Helen Schneider Hospital for Women, Rabin Medical Center, Petach Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Best Pract Res Clin Obstet Gynaecol. 2015 Feb;29(2):225-36. doi: 10.1016/j.bpobgyn.2014.04.020. Epub 2014 Aug 20.
Gestational diabetes mellitus (GDM) complicates 3-15% of pregnancies depending upon the geographic location and ethnic groups, and its incidence is estimated to increase even further due to the increasing rates of obesity in the general population and the trend towards advanced maternal age in pregnancy. GDM is associated with adverse pregnancy outcome such as an increased rate of fetal macrosomia, neonatal metabolic disturbances, and maternal injuries. It has been shown that there is an inverse relation between maternal glycemic control and the risk of complications. When diet and exercise therapy fail in achieving good glycemic control, pharmacological intervention is warranted. This chapter deals with the evidence regarding the various pharmacological interventions for glycemic control in women with GDM, when to start, and what pharmacological agent to use.
妊娠期糖尿病（GDM）在3%至15%的妊娠中出现并发症，具体比例取决于地理位置和种族群体。由于普通人群肥胖率上升以及孕期产妇年龄增大的趋势，其发病率预计还会进一步增加。GDM与不良妊娠结局相关，如巨大儿发生率增加、新生儿代谢紊乱和母体损伤。研究表明，母体血糖控制与并发症风险呈负相关。当饮食和运动疗法未能实现良好的血糖控制时，就需要进行药物干预。本章探讨了有关GDM女性血糖控制的各种药物干预措施、何时开始以及使用何种药物的证据。
