Saleh A K, al-Muhtaseb N, Gumaa K A, Mubarak A, Shaker M S
Department of Obstetrics and Gynecology, Faculty of Medicine, Kuwait University.
Horm Metab Res. 1989 Sep;21(9):507-13. doi: 10.1055/s-2007-1009273.
In order to advise regarding the religious practice of withholding food, we studied the metabolic changes after successive 15 days of recurrent fasting of 13 hours every day in maternal plasma and liquor amnii of obese normal gravids and gestational diabetics in their third trimester. There were no significant differences between those who fasted that period for one day prior to elective cesarean section (CS) and those who fasted the same period repeatedly for 15 days. The fasted gravids had significant rises in glycerol, beta-hydroxybutyrate (BOHB) and nonesterified fatty acids (NEFA) (P less than 0.0001, P less than 0.005 and P less than 0.01, respectively) in maternal plasma, compared to unfasted gravid groups and ungravid fasted group. No significant metabolic difference was found in the liquor amnii withdrawn from fasted and unfasted groups. The influence of such short term of starvation on the fetal metabolic profile was studied in the cord blood during cesarean section (CS). Glucose, glycerol and NEFA were significantly lower in arterial than in venous cord plasma (P less than 0.05, P less than 0.01 and P less than 0.01, respectively) indicating that the fetus could utilize these substrates. Positive correlation was found between the levels of BOHB in the mother and venous cord plasma on the one hand and their levels in the arterial cord plasma and liquor amnii on the other hand implying that this substrate passes unutilized through the fetus to the liquor amnii. A pregnant woman in the third trimester should not withhold food for long periods.
为了就禁食这种宗教习俗提供建议，我们研究了肥胖的正常孕妇和孕晚期妊娠糖尿病孕妇在连续15天每天禁食13小时后母血和羊水的代谢变化。在择期剖宫产（CS）前禁食一天的孕妇与反复禁食相同时间段15天的孕妇之间没有显著差异。与未禁食的孕妇组和非孕期禁食组相比，禁食的孕妇母血中甘油、β-羟基丁酸（BOHB）和非酯化脂肪酸（NEFA）显著升高（分别为P<0.0001、P<0.005和P<0.01）。在禁食组和未禁食组抽取的羊水中未发现显著的代谢差异。在剖宫产期间，对脐带血中这种短期饥饿对胎儿代谢特征的影响进行了研究。脐动脉血浆中的葡萄糖、甘油和NEFA显著低于脐静脉血浆（分别为P<0.05、P<0.01和P<0.01），这表明胎儿可以利用这些底物。一方面，母亲和脐静脉血浆中BOHB的水平与另一方面脐动脉血浆和羊水中BOHB的水平之间存在正相关，这意味着这种底物未被胎儿利用，而是通过胎儿进入羊水。孕晚期的孕妇不应长时间禁食。
