Kitzmiller J L, Brown E R, Phillippe M, Stark A R, Acker D, Kaldany A, Singh S, Hare J W
Am J Obstet Gynecol. 1981 Dec 1;141(7):741-51. doi: 10.1016/0002-9378(81)90698-0.
We studied the effect of diabetic nephropathy on the course of pregnancy, perinatal outcome, and infant development and determined the influence of pregnancy on maternal hypertension and renal function. Maternal proteinuria usually increased during pregnancy (greater than 3 gm/24 hours in 69%), and hypertension was present by the third trimester in 73%. The degree of proteinuria correlated with diastolic pressure and creatinine clearance. After pregnancy, proteinuria declined in 65% of the mothers, hypertension was absent in 43.5%, and the expected rate of fall in creatinine clearance was not accelerated. Among 35 patients, abortion occurred spontaneously or was performed electively in 25.7%, and 71% of the remainder underwent delivery before 37 weeks. Birth weight was related to maternal blood pressure and creatinine clearance. Neonatal morbidity was common, but the perinatal survival rate was 89%. Infants seen at follow-up without congenital anomalies had normal development at 8 to 36 months of age. We concluded that perinatal outcome has significantly improved for diabetic women with nephropathy.
我们研究了糖尿病肾病对妊娠过程、围产期结局及婴儿发育的影响，并确定了妊娠对母亲高血压和肾功能的影响。母亲蛋白尿在孕期通常会增加（69%的患者超过3克/24小时），73%的患者在妊娠晚期出现高血压。蛋白尿程度与舒张压及肌酐清除率相关。产后，65%的母亲蛋白尿减少，43.5%的母亲血压恢复正常，肌酐清除率的预期下降速率未加快。35例患者中，25.7%自然流产或选择人工流产，其余患者中71%在37周前分娩。出生体重与母亲血压及肌酐清除率相关。新生儿发病率常见，但围产期存活率为89%。随访中未发现先天性异常的婴儿在8至36个月龄时发育正常。我们得出结论，患有肾病的糖尿病女性围产期结局已显著改善。
