Cope E V, Sultana N, Masson E A, Allen B J, Oboh A, Wilkinson L, Wood C, Lindow S W
Hull York Medical School, Women and Childrens' Hospital, Hull Royal Infirmary, Hull,UK.
Department Diabetes and Endocrinology, Women and Childrens' Hospital, Hull Royal Infirmary, Hull, UK.
J Neonatal Perinatal Med. 2017;10(1):25-31. doi: 10.3233/NPM-915148.
Women with diabetes may need elective preterm delivery due to pregnancy or diabetes related complications. The aim of this study was to describe the neonatal outcomes arising from elective preterm delivery in diabetic women.
Suitable patients were identified by the obstetric team at Hull Royal Infirmary Women and Children's Hospital and data was extracted from their case notes. 45 diabetic women with planned preterm delivery were identified within a set time frame, resulting in 48 babies.
Of the 48 babies born, 47 survived. 36 out of 48 were delivered via caesarean section. Gestational ages ranged from 29+3 to 36+6 weeks, and 24 out of 48 (50%) had a birth weight greater than the 90th centile for gestational age.34 out of the 48 babies experienced some form of neonatal complication and were admitted to the neonatal unit. The median duration of stay in the neonatal unit was 7 days. 14 of the surviving neonates suffered from respiratory distress, although only 4 required surfactant therapy to regain respiratory function. However, the incidence of serious neonatal complications in those born after 34 weeks was shown to be low.
Elective preterm delivery after 34 weeks had little effect on overall neonatal outcome. Therefore it could be proposed that elective preterm delivery after 34 weeks gestation may be an acceptable option in diabetic women if there are maternal or obstetric complications.
患有糖尿病的女性可能因妊娠或糖尿病相关并发症而需要择期早产。本研究的目的是描述糖尿病女性择期早产所产生的新生儿结局。
合适的患者由赫尔皇家医院妇女儿童医院的产科团队确定,并从她们的病历中提取数据。在规定的时间范围内确定了45名计划早产的糖尿病女性,共分娩48名婴儿。
48名出生的婴儿中,47名存活。48名中有36名通过剖宫产分娩。孕周范围为29 + 3至36 + 6周,48名中有24名(50%)出生体重高于孕周的第90百分位数。48名婴儿中有34名经历了某种形式的新生儿并发症,并被收治入新生儿病房。在新生儿病房的中位住院时间为7天。14名存活的新生儿患有呼吸窘迫,尽管只有4名需要使用表面活性剂治疗以恢复呼吸功能。然而,34周后出生的婴儿中严重新生儿并发症的发生率较低。
34周后的择期早产对总体新生儿结局影响不大。因此,可以提出,如果存在母体或产科并发症,妊娠34周后的择期早产对于糖尿病女性可能是一个可接受的选择。