Endocrinology and Obstetric Medicine, Mater Health Services, Head of UQ Mater Clinical Unit, University of Queensland, Whitty Building Level 1, Raymond Terrace, South Brisbane, Qld 4101, Australia. Electronic address: http://www.mater.org.au.
Department of Obstetrics and Gynecology, Medical University of Graz, Auenbruggerplatz 14, 8036 Graz, Austria.
Diabetes Res Clin Pract. 2018 Nov;145:5-14. doi: 10.1016/j.diabres.2018.03.026. Epub 2018 Mar 27.
Hyperglycemia in pregnancy (HIP) is recognized as a major underlying cause of pregnancy complications and a contributing cause to health risks throughout the subsequent life of both mothers and babies, with amplification of the global epidemic of non-communicable diseases. Although some aspects of these associations are well described, detailed understanding of basic pathophysiologic mechanisms is lacking. Improved fundamental scientific knowledge must be developed to allow logical strategies for prevention and treatment. During pregnancy, much work is required to replace current empirical approaches to diagnosis and treatment of HIP with evidence based protocols, pragmatically adapted to differing health care and health economic contexts. Further, a life cycle approach to HIP, the risk of immediate pregnancy complications and later health risks to mother and baby must be developed and implemented across a wide range of health care environments. This document aims to outline key focus areas for further basic, epidemiologic, clinical and implementation research in this important area.
妊娠高血糖(HIP)被认为是导致妊娠并发症的主要潜在原因,也是导致母婴在随后的生活中面临健康风险的原因之一,加剧了全球非传染性疾病的流行。尽管这些关联的某些方面已经得到了很好的描述,但对基本病理生理机制的详细了解仍有所欠缺。为了制定合理的预防和治疗策略,必须发展更好的基础科学知识。在怀孕期间,需要做大量的工作,用基于证据的方案来替代目前对 HIP 的诊断和治疗的经验性方法,根据不同的医疗保健和卫生经济环境进行务实的调整。此外,必须在广泛的医疗保健环境中制定和实施针对 HIP 、妊娠并发症的即时风险以及母婴后期健康风险的生命周期方法。本文旨在概述这一重要领域进一步进行基础、流行病学、临床和实施研究的重点领域。