Wright A D, Taylor K G, Nicholson H O, Insley J, Evans S E
Postgrad Med J. 1982 Jul;58(681):411-4. doi: 10.1136/pgmj.58.681.411.
The results of management of 128 consecutive pregnancies occuring in diabetic patients who received insulin from before conception and throughout pregnancy are described. Mean maternal blood glucose levels were at least 1 mmol/litre greater than levels reported in normal pregnancy. Thirty-nine percent of the neonates had significant morbidity; respiratory distress syndrome (7·7%), hypocalcaemia (4·6%) and polycythaemia (10%) could be related to higher maternal blood glucose levels. Neonatal hypoglycaemia (9·2%), hyperbilirubinaemia (13·8%) and birth weight corrected for gestational age were not directly related to maternal blood glucose. This degree of maternal blood glucose control has reduced the large for dates infants (greater than 90th centile for gestational age) to 7%. Further reduction in the morbidity of infants of diabetic mothers requires studies of physiological maternal blood glucose levels which may not be possible with conventional insulin treatment as well as further efforts to reduce prematurity.
本文描述了128例糖尿病患者连续妊娠的治疗结果，这些患者在受孕前及整个孕期均接受胰岛素治疗。孕妇平均血糖水平比正常妊娠报道的水平至少高1毫摩尔/升。39%的新生儿有明显的发病率；呼吸窘迫综合征（7.7%）、低钙血症（4.6%）和红细胞增多症（10%）可能与孕妇血糖水平较高有关。新生儿低血糖（9.2%）、高胆红素血症（13.8%）以及根据胎龄校正的出生体重与孕妇血糖无直接关系。这种孕妇血糖控制程度已将大于孕周的巨大儿（大于胎龄第90百分位数）比例降至7%。要进一步降低糖尿病母亲所生婴儿的发病率，需要研究孕妇生理血糖水平，而传统胰岛素治疗可能无法做到这一点，同时还需要进一步努力降低早产率。
