Oakley N W, Beard R W, Turner R C
Br Med J. 1972 Feb 19;1(5798):466-9. doi: 10.1136/bmj.1.5798.466.
The effect of prolonged maternal hyperglycaemia on fetal plasma glucose and insulin concentrations was investigated in eight normal and nine diabetic patients. It was found that under fasting conditions the fetal glucose concentration in gestational diabetic pregnancies tended to be lower than in normal pregnancies. Insulin measurements suggested that this may be due to fetal hyperinsulinism in the diabetic group. During glucose infusion, regardless of the degree of maternal hyperglycaemia, the fetal glucose concentration was limited in 12 out of 13 cases to less than 200 mg/100 ml, with only small differences between normal and diabetic pregnancies. It is proposed that the placenta prevents unlimited transport of glucose to the fetus; yet in diabetic pregnancies a sequence of increased maternal-fetal glucose transport, fetal hyperinsulinism, and fetal hypoglycaemia may contribute to the observed perinatal mortality.
对8名正常孕妇和9名糖尿病孕妇研究了母体长期高血糖对胎儿血浆葡萄糖和胰岛素浓度的影响。结果发现，在空腹条件下，妊娠期糖尿病孕妇的胎儿葡萄糖浓度往往低于正常孕妇。胰岛素测量结果表明，这可能是由于糖尿病组胎儿存在高胰岛素血症。在输注葡萄糖期间，无论母体高血糖程度如何，13例中有12例胎儿葡萄糖浓度限制在200mg/100ml以下，正常孕妇和糖尿病孕妇之间只有微小差异。有人提出，胎盘可防止葡萄糖无限制地转运至胎儿；然而，在糖尿病妊娠中，母体-胎儿葡萄糖转运增加、胎儿高胰岛素血症和胎儿低血糖这一系列情况可能导致观察到的围产期死亡率。
