Naeye R L
Ciba Found Symp. 1978(63):227-41. doi: 10.1002/9780470720462.ch11.
In a large prospective study of pregnancy the perinatal mortality rate was 141/1000 births for diabetic gestations in which the onset of labour was spontaneous, 33/1000 for diabetic gestations in which labour was induced or the infant delivered by Caesarean section and 34/1000 for the non-diabetics. Forty per cent of the perinatal mortality excess in the diabetics was due to the consequences of maternal vascular lesions, i.e. large placental infarcts and marked retardation of placental growth. Seventeen per cent of the perinatal mortality excess was related to maternal acidosis or to insulin shock, 12% to severe congenital anomalies, 12% to the complications of Caesarean sections and the remainder to other disorders. Mothers with diabetes mellitus had more than twice the frequency of atheromata, fibrinoid change and thrombi in decidual arteries as non-diabetic mothers. Histological grading revealed that overweight newborns of diabetic mothers had immature lungs by comparison with the lungs of normally grown infants of diabetic mothers and infants of non-diabetic mothers. Low IQ values and an excess of neurological abnormalities in children of diabetic mothers who were ketotic during pregnancy were found to be due to amniotic fluid bacterial infections and their complications rather than to the maternal ketosis.
在一项关于妊娠的大型前瞻性研究中，自然发动分娩的糖尿病妊娠围产期死亡率为每1000例分娩中有141例，引产或剖宫产分娩的糖尿病妊娠围产期死亡率为每1000例中有33例，非糖尿病患者为每1000例中有34例。糖尿病患者围产期死亡率过高的40% 是由于母体血管病变的后果，即大面积胎盘梗死和胎盘生长明显迟缓。围产期死亡率过高的17% 与母体酸中毒或胰岛素休克有关，12% 与严重先天性畸形有关，12% 与剖宫产并发症有关，其余与其他疾病有关。患有糖尿病的母亲蜕膜动脉中动脉粥样硬化、纤维蛋白样改变和血栓的发生率是非糖尿病母亲的两倍多。组织学分级显示，与糖尿病母亲的正常生长婴儿和非糖尿病母亲的婴儿相比，糖尿病母亲的超重新生儿肺部不成熟。发现孕期酮症的糖尿病母亲的孩子智商值低且神经异常过多是由于羊水细菌感染及其并发症，而非母体酮症。
