Willis Kent, Alexander Charlotte, Sheiner Eyal
Our Lady of the Lake Children's Hospital, 7777 Hennessy Boulevard, Suite 6003, Baton Rouge, LA, 70808, USA.
The Medical School for International Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
Curr Diab Rep. 2016 Apr;16(4):21. doi: 10.1007/s11892-016-0716-8.
Gestational diabetes mellitus (GDM) is an increasingly common obstetrical problem. Due to the global escalation in the prevalence of obesity, as many as 15 % of pregnant women may soon be classified as having GDM. While often not diagnosed until late gestation, GDM is now recognized as a disorder of glucose and lipid metabolism, systemic inflammation, and insulin resistance that begins early in pregnancy. Recent large randomized trials have clarified the risk of maternal and neonatal complications caused by GDM, as well as the potential to ameliorate these risks. There is significant interest in the potential to reduce the risk for developing GDM in obese women through the performance of bariatric surgery (BS) before pregnancy. BS significantly reduces the risk for GDM, preeclampsia, and large neonates. However, it seems that the risk for small neonates and preterm delivery is increased. No significant differences are observed in regard to cesarean section, postpartum hemorrhage, or perinatal mortality. In this article, we address the effects of GDM on the mother and child, and explore the risks and benefits of BS in the obstetrical population.
妊娠期糖尿病（GDM）是一个日益常见的产科问题。由于全球肥胖患病率不断上升，多达15%的孕妇可能很快会被归类为患有GDM。虽然GDM通常直到妊娠晚期才被诊断出来，但现在它被认为是一种在妊娠早期就开始的糖脂代谢、全身炎症和胰岛素抵抗紊乱。最近的大型随机试验已经明确了GDM导致的母婴并发症风险，以及改善这些风险的可能性。通过在怀孕前进行减肥手术（BS）来降低肥胖女性患GDM风险的潜力引起了人们极大的兴趣。BS显著降低了患GDM、先兆子痫和巨大儿的风险。然而，似乎低体重儿和早产的风险增加了。在剖宫产、产后出血或围产期死亡率方面未观察到显著差异。在本文中，我们阐述了GDM对母婴的影响，并探讨了BS在产科人群中的风险和益处。
