Chinese University of Hong Kong, Hong Kong Special Administrative Region; King's College, London, England, United Kingdom.
Mater Research, University of Queensland, Australia.
Diabetes Res Clin Pract. 2018 Nov;145:20-30. doi: 10.1016/j.diabres.2018.05.002. Epub 2018 May 29.
The International Federation of Gynecology and Obstetrics (FIGO) has identified non communicable maternal diseases (NCDs) as a new focus area. NCDs and exposures as related to pregnancy complications and later impairment of maternal and offspring health will form the basis for action in the forthcoming years. This paper summarizes recent advances, centered on the use of first-trimester testing, as a window of opportunity to predict and prevent many pregnancy complications; and for potential future prevention of NCDs in mother and offspring. Recent results from a large-scale randomized control trial have provided definitive proof that effective screening for preterm preeclampsia (preterm-PE), requiring delivery before 37 weeks' gestation, can be achieved with a combined test of maternal factors and biomarkers at 11-13 weeks and that aspirin, given to high-risk women, is effective in reducing the risk of preterm-PE and the length of stay in neonatal intensive care unit. This is the first successful example to illustrate that pregnancy complications is predictable and preventable in early pregnancy. Similar prediction and prevention strategies are being developed for hyperglycemia in pregnancy and preterm birth, with the intention for longer lasting interventions leading to significant downstream impact in improving long-term health in both mothers and babies.
国际妇产科联合会（FIGO）已将非传染性孕产妇疾病（NCDs）确定为新的重点领域。与妊娠并发症以及随后母婴健康受损相关的 NCDs 和暴露因素将成为未来几年行动的基础。本文总结了最近的进展，重点是使用早期妊娠检测作为预测和预防许多妊娠并发症的机会窗口；并为母婴未来潜在的 NCD 预防提供了可能。一项大规模随机对照试验的最新结果提供了确凿的证据，证明可以通过在 11-13 周时对母体因素和生物标志物进行联合检测来有效筛查早产子痫前期（早产-PE），需要在 37 周前分娩，并且给予高危妇女阿司匹林可有效降低早产-PE 的风险和新生儿重症监护病房的住院时间。这是第一个成功的例子，说明了妊娠并发症在早期妊娠是可预测和可预防的。正在为妊娠期间的高血糖和早产开发类似的预测和预防策略，目的是进行更持久的干预，从而对改善母婴长期健康产生重大的下游影响。
