Nordlander E, Hanson U, Persson B
Department of Obstetrics and Gynecology, Karolinska Hospital, Stockholm, Sweden.
Br J Obstet Gynaecol. 1989 Jun;96(6):671-8. doi: 10.1111/j.1471-0528.1989.tb03281.x.
The influence of obstetric factors and indices of maternal blood glucose control on neonatal morbidity was examined in 261 women with gestational diabetes. A reference group of 218 women, matched for age and day of delivery, within 1 week, was used for comparison. Perinatal morbidity was significantly more frequent in the gestational diabetic pregnancies (23%) than in the reference group (13%), whereas the occurrence of large-for-gestational-age infants was not different between the groups. Infants born to women with gestational diabetes were categorized to a no-morbidity group (n = 200) and a morbidity group (n = 61). The group with morbidity had significantly shorter gestational age at delivery, higher frequency of caesarean section, higher maternal pre-pregnancy weight and higher area under the glucose tolerance curve. There was no significant difference in third-trimester blood glucose between the groups. Discriminant analysis revealed that the most significant influence on neonatal morbidity was gestational age at delivery. After correction for this factor the only factor with added significance for neonatal morbidity was maternal pre-pregnancy weight. The present study clearly illustrates that other factors beside blood glucose control are of importance for neonatal outcome in gestational diabetic pregnancy.
在261例妊娠期糖尿病妇女中，研究了产科因素及母体血糖控制指标对新生儿发病率的影响。选取218例年龄和分娩日期相匹配（在1周内）的妇女作为参照组进行比较。妊娠期糖尿病孕妇围产期发病率（23%）显著高于参照组（13%），而两组间大于胎龄儿的发生率无差异。妊娠期糖尿病妇女所生婴儿分为无发病组（n = 200）和发病组（n = 61）。发病组分娩时孕周明显较短，剖宫产频率较高，母体孕前体重较高，葡萄糖耐量曲线下面积较大。两组间孕晚期血糖无显著差异。判别分析显示，对新生儿发病率影响最显著的是分娩时孕周。校正该因素后，对新生儿发病率有额外显著影响的唯一因素是母体孕前体重。本研究清楚地表明，除血糖控制外，其他因素对妊娠期糖尿病孕妇的新生儿结局也很重要。
