Caughey Aaron B, Valent Amy M
Department of Obstetrics and Gynecology, Oregon Health and Science University, Portland, Oregon.
Am J Perinatol. 2016 Nov;33(13):1250-1254. doi: 10.1055/s-0036-1585589. Epub 2016 Jul 19.
The prevalence of pregestational diabetes and the incidence of gestational diabetes have both increased over recent years. One component of the management of diabetes in pregnancy is the timing of delivery in the late-preterm, early-term, or full-term periods. Recent guidance from the National Institute for Child Health and Human Development, Society for Maternal-Fetal Medicine, and American College of Obstetricians and Gynecologists has lacked specificity, for example, recommending delivery for women with pregestational diabetes with poorly controlled glucose levels to be from 34 to 39 weeks' gestation. This lack of specificity is predominant because of the large holes in existing data to guide clinical practice. This article reviews existing literature regarding diabetes in pregnancy and attempts to give an analytical framework and some clearer guidance around the timing of delivery.
近年来，孕前糖尿病的患病率和妊娠期糖尿病的发病率均有所上升。妊娠糖尿病管理的一个组成部分是在晚期早产、早期足月或足月时的分娩时机。美国国家儿童健康与人类发展研究所、母胎医学协会以及美国妇产科医师学会最近发布的指南缺乏特异性，例如，建议血糖控制不佳的孕前糖尿病女性在妊娠34至39周分娩。由于现有数据存在很大漏洞，无法为临床实践提供指导，这种特异性的缺乏很普遍。本文回顾了关于妊娠糖尿病的现有文献，并试图给出一个分析框架以及一些关于分娩时机的更明确的指导。
