Obstetrics and Gynaecology Specialist, Senior Clinical fellow at Obstetrics and Gynaecology Department, University College London Hospital, 25 Grafton Way, London, WC1E 6DB, UK.
Obstetrics and Gynaecology Department, University College London Hospital, 25 Grafton Way, London, WC1E 6DB, UK.
Placenta. 2024 Sep 2;154:220-223. doi: 10.1016/j.placenta.2024.07.054. Epub 2024 Jul 20.
Gestational diabetes mellitus (GDM) is a known risk factor for stillbirth (Rosenstein et al., 2012) [1]. Delayed villous maturation (DVM), predominantly seen in term placentas in pregnancies complicated with glucose dysmetabolism, may in part be a consequence of excessive maternal glucose leading to release of fetal insulin and other growth factors that promote excessive placental growth at the expense of villous maturation (Redline, 2012) [2].
We present three cases of under-diagnosed/treated glucose dysmetabolism in women in their first pregnancies cared for in other hospitals in the United Kingdom (UK) with the fatal fetal/neonatal outcomes and confirmed DVM in the placenta and congenital pneumonia on post-mortem examination in all three cases.
This cluster supports a hypothesis that DVM and glucose dysmentabolism may make babies more susceptible to severe perinatal infection. All three cases received the antenatal care in their subsequent pregnancies in our unit and had confirmed glucose dysmetabolism which was treated and resulted in healthy babies.
妊娠糖尿病（GDM）是导致死胎的已知危险因素（Rosenstein 等人，2012）[1]。在葡萄糖代谢紊乱的妊娠中，足月胎盘中主要表现为绒毛成熟延迟（DVM），这可能部分是由于母体葡萄糖过多导致胎儿胰岛素和其他生长因子释放，从而促进胎盘过度生长，而绒毛成熟受损（Redline，2012）[2]。
我们介绍了英国（UK）其他医院治疗的 3 例初产妇葡萄糖代谢紊乱的漏诊/治疗病例，这 3 例病例均出现致命性胎儿/新生儿结局，胎盘绒毛成熟不良，且所有病例均在死后检查中确诊为先天性肺炎。
这组病例支持了一种假设，即 DVM 和葡萄糖代谢紊乱可能使婴儿更容易受到严重围产期感染的影响。所有 3 例病例在我们单位接受了后续妊娠的产前护理，并确诊了葡萄糖代谢紊乱，经过治疗后产下了健康的婴儿。
