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糖尿病女性的妊娠结局——糖尿病类型及治疗的影响

Pregnancy outcomes in women with diabetes mellitus - the impact of diabetes type and treatment.

作者信息

Bapayeva Gauri, Terzic Sanja, Dotlic Jelena, Togyzbayeva Karligash, Bugibaeva Ulzhan, Mustafinova Madina, Alisheva Assem, Garzon Simone, Terzic Milan, Laganà Antonio Simone

机构信息

Clinical Academic Department of Women's Health, Corporate Fund "University Medical Center", Nur-Sultan, Kazakhstan.

Department of Medicine, School of Medicine, Nazarbayev University, Nur-Sultan, Kazakhstan.

出版信息

Prz Menopauzalny. 2022 Mar;21(1):37-46. doi: 10.5114/pm.2022.113781. Epub 2022 Feb 21.

Abstract

INTRODUCTION

It has been estimated that approximately 16% of pregnancies worldwide are affected by pre-existing or gestational insulin-dependent (type 1) or independent (type 2) diabetes mellitus (DM). Diabetes mellitus in pregnancy remains a high-risk condition for both mother and child. This study aimed to investigate pregnancy outcomes regarding DM types.

MATERIAL AND METHODS

The study included 323 DM patients delivered for 6 years (2012-2017). General and obstetric history data and all complications throughout the pregnancy and the early neonatal period were noted. Based on DM type, women were divided into 4 groups: pre-pregnancy/pre-existing DM, insulin-dependent or independent, and gestational diabetes mellitus with or without insulin therapy.

RESULTS

The majority of women had pre-existing insulin-independent DM (type II 62%). Some types of pregnancy/maternal complications were registered in almost 85% of examined pregnancies. However, all babies were live born and mostly with good outcome (36.85% with early neonatal complications). Diabetes mellitus type could not predict the occurrence of neonatal complications ( = 0.342). Pre-existing insulin-dependent DM increased the risk for pregnancy complications ( = 0.031; OR = 1.656).

CONCLUSIONS

Diabetes mellitus type has a limited impact on pregnancy outcomes and the occurrence of maternal and neonatal complications. With adequate therapy the pregnancy outcome can be good regardless of DM type.

摘要

引言

据估计,全球约16%的妊娠受到孕前或孕期胰岛素依赖型(1型)或非胰岛素依赖型(2型)糖尿病(DM)的影响。妊娠糖尿病对母亲和孩子来说仍然是一种高危情况。本研究旨在调查不同类型糖尿病的妊娠结局。

材料与方法

该研究纳入了6年间(2012 - 2017年)分娩的323例糖尿病患者。记录了一般和产科病史数据以及整个孕期和新生儿早期的所有并发症。根据糖尿病类型,女性被分为4组:孕前/既往糖尿病,胰岛素依赖型或非胰岛素依赖型,以及接受或未接受胰岛素治疗的妊娠期糖尿病。

结果

大多数女性患有既往非胰岛素依赖型糖尿病(II型占62%)。在几乎85%的受检妊娠中记录了某些类型的妊娠/母体并发症。然而,所有婴儿均存活,且大多数结局良好(36.85%有早期新生儿并发症)。糖尿病类型无法预测新生儿并发症的发生(P = 0.342)。既往胰岛素依赖型糖尿病增加了妊娠并发症的风险(P = 0.031;OR = 1.656)。

结论

糖尿病类型对妊娠结局以及母体和新生儿并发症的发生影响有限。通过适当的治疗,无论糖尿病类型如何,妊娠结局都可能良好。

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