Abell D A
Br J Obstet Gynaecol. 1979 Mar;86(3):214-21. doi: 10.1111/j.1471-0528.1979.tb10596.x.
Maternal hypoglycaemia (plasma glucose below 5th centile) had a highly significant association with fetal growth retardation, and perinatal mortality was significantly increased in the presence of both hypoglycaemia and hyperglycaemia (plasma glucose above 95th centile) when pregnancy outcome was analyzed in 5000 consecutive patients who had a glucose tolerance test performed during the third trimester of pregnancy. This study confirms the significance of abnormal glucose tolerance as a causative factor of feto-placental dysfunction. The flat glucose tolerance test pattern had no significance beyond the presence of associated hypoglycaemia, but reactive hypoglycaemia, and persistent abnormalities of plasma glucose levels during the test, were associated with higher incidences of complicated outcome. Hypertonic dextrose therapy administered to the patient with persistently subnormal urinary oestriol excretion was less likely to cause a favourable response in oestriol excretion if glucose tolerance was abnormal, perhaps because the adverse influences of abnormal glucose tolerance were not reversible by the third trimester of pregnancy. Hypoglycaemia and hyperglycaemia, additional to diabetes mellitus, are significant factors in the aetiology and diagnosis of abnormal pregnancy, and point to the need to investigate therapeutic measures.
母亲低血糖（血浆葡萄糖低于第5百分位数）与胎儿生长受限高度相关，在对5000例在妊娠晚期进行葡萄糖耐量试验的连续患者的妊娠结局进行分析时，低血糖和高血糖（血浆葡萄糖高于第95百分位数）同时存在时围产期死亡率显著增加。本研究证实了糖耐量异常作为胎儿-胎盘功能障碍病因的重要性。平坦的糖耐量试验模式除了伴有低血糖外没有其他意义，但反应性低血糖以及试验期间血浆葡萄糖水平的持续异常与不良结局的发生率较高有关。对于尿雌三醇排泄持续低于正常水平的患者，如果糖耐量异常，给予高渗葡萄糖治疗不太可能使雌三醇排泄产生良好反应，这可能是因为糖耐量异常的不良影响在妊娠晚期无法逆转。除糖尿病外，低血糖和高血糖是异常妊娠病因和诊断中的重要因素，这表明需要研究治疗措施。
