Nelson R L
Mayo Clin Proc. 1986 Oct;61(10):825-9. doi: 10.1016/s0025-6196(12)64824-1.
In pregnant patients who have diabetes mellitus, metabolic control has been demonstrated to improve neonatal outcome considerably. All pregnant patients should be screened for gestational diabetes at 24 to 28 weeks of gestation with use of a glucose challenge test. Dietary therapy, and insulin therapy when appropriate, reduces the neonatal mortality associated with gestational diabetes to that of normal pregnancy. Macrosomia remains a problem, but aggressive use of insulin therapy may minimize this complication. Intensive control of insulin-dependent diabetes both before conception and during pregnancy is essential. The risk of congenital malformations can be reduced to that associated with normal pregnancy if diabetes is well controlled during the first 8 weeks of pregnancy. Neonatal survival, macrosomia, and hypoglycemia also are directly related to the degree of control of maternal diabetes during the pregnancy.
在患有糖尿病的孕妇中，已证明代谢控制可显著改善新生儿结局。所有孕妇均应在妊娠24至28周时使用葡萄糖耐量试验筛查妊娠期糖尿病。饮食疗法以及在适当时进行胰岛素治疗，可将与妊娠期糖尿病相关的新生儿死亡率降至正常妊娠水平。巨大儿仍然是一个问题，但积极使用胰岛素治疗可能会使这种并发症的发生降至最低。在受孕前和怀孕期间对胰岛素依赖型糖尿病进行强化控制至关重要。如果在妊娠的前8周糖尿病得到良好控制，先天性畸形的风险可降至与正常妊娠相关的水平。新生儿存活率、巨大儿和低血糖也与孕期母亲糖尿病的控制程度直接相关。
