Gabbe S G, Mestman J H, Freeman R K, Goebelsmann U T, Lowensohn R I, Nochimson D, Cetrulo C, Quilligan E J
Am J Obstet Gynecol. 1977 Dec 1;129(7):723-32. doi: 10.1016/0002-9378(77)90388-x.
During the period 1971 to 1975, 260 women with diabetes mellitus, Classes B through R, were delivered of their infants at Los Angeles County Women's Hospital. The plan of patient management included frequent clinic visits and hospitalization to assure good control. A program of intensive antepartum fetal surveillance was begun at 34 weeks' gestation, with the use of daily 24 hour urinary estriol determinations and a weekly contraction stress test (CST). A lecithin/sphingomyelin ratio was evaluated for all patients before elective delivery. The perinatal mortality rate in these diabetic pregnant women was 46 per 1,000 as compared to 24 per 1,000 in the general population. Only three stillbirths occurred in the diabetic group, none within one week of a negative CST. Congenital malformations were responsible for almost half of the neonatal deaths. There were no deaths due to iatrogenic prematurity or trauma. Mean gestational age at delivery was 37.9 weeks and vaginal delivery was the mode for approximately half of the women. Two thirds of the infants did experience some morbidity.
1971年至1975年期间，260名患有B级至R级糖尿病的女性在洛杉矶县妇女医院分娩。患者管理计划包括频繁的门诊就诊和住院治疗，以确保良好的病情控制。在妊娠34周时开始实施强化产前胎儿监测计划，采用每日24小时尿雌三醇测定和每周一次的宫缩应激试验（CST）。在择期分娩前对所有患者进行卵磷脂/鞘磷脂比值评估。这些糖尿病孕妇的围产期死亡率为每1000例46例，而普通人群为每1000例24例。糖尿病组仅发生3例死产，在CST阴性后一周内无死产发生。先天性畸形导致了近一半的新生儿死亡。没有因医源性早产或创伤导致的死亡。分娩时的平均孕周为37.9周，约一半的女性采用阴道分娩方式。三分之二的婴儿确实出现了一些并发症。
