Gabbe S G, Lowensohn R I, Wu P Y, Guerra G
Diabetes Care. 1978 Nov-Dec;1(6):335-9. doi: 10.2337/diacare.1.6.335.
Recent advances in antepartum fetal evaluation have contributed to a marked reduction in fetal deaths in pregnancies complicated by overt diabetes mellitus. To determine the effect of these changes on neonatal morbidity and mortality, a retrospective analysis of complications in 322 infants of diabetic mothers (IDM) in White classes B--R was undertaken. The majority (89 per cent) of the IDM were delivered at term with a mean gestational age of 38 weeks. Neonatal morbidity correlated significantly with gestational age, occurring in 80 per cent of the preterm and 40 per cent of the term infants. The overall incidence of complications was: hyperbilirubinemia 37 per cent, hypoglycemia 31 per cent, hypocalcemia 13 per cent, polycythemia 8 per cent, and necrotizing enterocolitis 2 per cent. Respiratory distress syndrome (RDS) occurred in 9 per cent and congenital malformations in 6 per cent of the infants. Nine infants died, and four of these deaths were due to anomalies. These data indicate that (1) a reduction in fetal mortality has been accompanied by a reduction in neonatal mortality; (2) neonatal morbidity has been decreased but remains significant in the IDM; and (3) congenital anomalies have replaced RDS as a major cause of neonatal death for the IDM.
产前胎儿评估的最新进展显著降低了患有显性糖尿病的孕妇的胎儿死亡率。为了确定这些变化对新生儿发病率和死亡率的影响，对322例B - R级糖尿病母亲的婴儿（IDM）的并发症进行了回顾性分析。大多数（89%）IDM在足月时分娩，平均孕周为38周。新生儿发病率与孕周显著相关，早产婴儿中发病率为80%，足月婴儿中为40%。并发症的总体发生率为：高胆红素血症37%，低血糖症31%，低钙血症13%，红细胞增多症8%，坏死性小肠结肠炎2%。9%的婴儿发生呼吸窘迫综合征（RDS），6%的婴儿有先天性畸形。9名婴儿死亡，其中4例死于畸形。这些数据表明：（1）胎儿死亡率的降低伴随着新生儿死亡率的降低；（2）新生儿发病率有所下降，但在IDM中仍然显著；（3）先天性畸形已取代RDS成为IDM新生儿死亡的主要原因。
