Endo Sho, Saisho Yoshifumi, Miyakoshi Kei, Ochiai Daigo, Matsumoto Tadashi, Kawano Yoshinaga, Mitsuishi Masanori, Irie Junichiro, Tanaka Masami, Meguro Shu, Tanaka Mamoru, Itoh Hiroshi
Department of Internal Medicine, Keio University School of Medicine, Tokyo 160-8582, Japan.
Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo 160-8582, Japan.
J Clin Med. 2018 Jan 2;7(1):5. doi: 10.3390/jcm7010005.
The aim of this study was to clarify the association of maternal factors with perinatal complications in pregnancies complicated with type 1 (T1D) or type 2 diabetes (T2D).
We conducted a retrospective chart review and enrolled 26 Japanese pregnant women with diabetes who received perinatal care at our hospital between 2008 and 2015. Perinatal complications were defined as one or more of the following: miscarriage, fetal death, fetal dysfunction, fetal structural anomaly, small-for-gestational age, large-for-gestational age (LGA), premature birth, neonatal hypoglycemia, pregnancy-induced hypertension (PIH), deterioration of maternal kidney function, and urgent Caesarean section (CS). The associations between perinatal complications and maternal factors were examined.
Approximately 70% and 50% of women with T1D and T2D experienced perinatal complications, respectively. LGA, neonatal hypoglycemia, and urgent CS were major perinatal complications in women with T1D, while PIH and urgent CS were major complications in those with T2D. In women with T1D, pre-gestational HbA1c was significantly higher in women with perinatal complications than in those without. In women with T2D, pre-gestational body mass index was significantly higher in women with perinatal complications than in those without.
These findings suggest that while pre-gestational glycemic control remains the most important issue in women with T1D, pre-gestational weight control in addition to glycemic control should be greater emphasized in women with T2D to reduce the risk of perinatal complications.
本研究旨在阐明1型糖尿病(T1D)或2型糖尿病(T2D)合并妊娠时母体因素与围产期并发症之间的关联。
我们进行了一项回顾性病历审查,纳入了2008年至2015年间在我院接受围产期护理的26名日本糖尿病孕妇。围产期并发症定义为以下一种或多种:流产、胎儿死亡、胎儿功能障碍、胎儿结构异常、小于胎龄儿、大于胎龄儿(LGA)、早产、新生儿低血糖、妊娠高血压综合征(PIH)、母体肾功能恶化以及急诊剖宫产(CS)。研究了围产期并发症与母体因素之间的关联。
T1D和T2D女性中分别约有70%和50%经历了围产期并发症。LGA、新生儿低血糖和急诊CS是T1D女性的主要围产期并发症,而PIH和急诊CS是T2D女性的主要并发症。在T1D女性中,发生围产期并发症的女性孕前糖化血红蛋白(HbA1c)显著高于未发生并发症的女性。在T2D女性中,发生围产期并发症的女性孕前体重指数显著高于未发生并发症的女性。
这些发现表明,虽然孕前血糖控制仍然是T1D女性最重要的问题,但对于T2D女性,除血糖控制外,还应更加强调孕前体重控制,以降低围产期并发症的风险。