Karcz Karolina, Królak-Olejnik Barbara
Department of Neonatology, Wroclaw Medical University, 50-367 Wrocław, Poland.
Nutrients. 2024 Nov 27;16(23):4093. doi: 10.3390/nu16234093.
Gestational diabetes mellitus (GDM) is one of the most prevalent complications associated with pregnancy, exhibiting a gradual rise in prevalence worldwide. Given the potential for numerous short- and long-term complications for both mother and child, patients diagnosed with GDM require individualised treatment to compensate for metabolic abnormalities and ultimately reduce the risk of the known adverse consequences of impaired glucose tolerance.
The manuscript presents a summary of the current knowledge on changes in maternal metabolism during physiological pregnancy and pregnancy complicated by gestational diabetes. Furthermore, the article provides a synthesis of the findings from recent research examining the impacts of gestational diabetes and the therapeutic modalities employed on the nutritional status of the fetus and neonate. Additionally, the review elucidates the function of the placenta and placental hormones in fetal development, as well as the impact of hyperglycemia, insulin resistance and adipokines on fetal and neonatal nutritional programming and predisposition to metabolic complications in adulthood.
The metabolic environment, resulting from abnormal glucose tolerance during pregnancy, exerts a particularly significant impact on fetal growth and, consequently, on the birth weight and fat mass of the newborn infants. This is a pivotal factor influencing the nutritional and metabolic programming of the developing fetus, predisposing the individual to the development of metabolic complications throughout their lifetime.
妊娠期糖尿病（GDM）是与妊娠相关的最常见并发症之一，在全球范围内其患病率呈逐渐上升趋势。鉴于母婴均有可能出现众多短期和长期并发症，被诊断为GDM的患者需要个体化治疗，以弥补代谢异常，最终降低糖耐量受损所导致的已知不良后果的风险。
本文总结了关于生理妊娠及合并妊娠期糖尿病的妊娠期间母体代谢变化的当前知识。此外，本文还综合了近期研究的结果，这些研究探讨了妊娠期糖尿病及其治疗方式对胎儿和新生儿营养状况的影响。此外，该综述阐明了胎盘及胎盘激素在胎儿发育中的作用，以及高血糖、胰岛素抵抗和脂肪因子对胎儿和新生儿营养编程及成年后发生代谢并发症易感性的影响。
妊娠期间糖耐量异常所导致的代谢环境，对胎儿生长具有特别显著的影响，进而影响新生儿的出生体重和脂肪量。这是影响发育中胎儿营养和代谢编程的关键因素，使个体在其一生中易发生代谢并发症。
