Peterson K A, Peterson A M, Corbett V, Tongen S, Guzman M, Mazze R
Department of Family Practice and Community Health, University of Minnesota, St Paul 55106.
J Fam Pract. 1994 Dec;39(6):558-63.
Recent evidence suggests that infant morbidity is increased among women who have abnormal prenatal glucose screening tests but who do not have gestational diabetes mellitus (GDM). These women fall into a diagnostic gray zone and historically have not been treated.
Forty-eight pregnant women with abnormal oral glucose challenge test results performed self-monitored blood glucose (SMBG) testing seven times per day for 1 week before undergoing a diagnostic 100-g oral glucose tolerance test (OGTT). At delivery, perinatal complications and birthweights were recorded. Results of SMBG tests for women with normal OGTTs were correlated with infant birthweights.
Thirteen infants (37%) were found to be large for gestational age (LGA). Significant correlation was found between increasing birthweight and increasing average fasting SMBG values (P < .001), increasing percentage of SMBG values above 120 mg/dL (6.7 mmol/L) (P < .01), and increasing average SMBG values (P < .016).
Maternal home glucose values at 28 weeks correlate with the risk of LGA infant births among women in the diagnostic gray zone. Women with average fasting SMBG values > 95 mg/dL (5.3 mmol/L) are at increased risk for giving birth to LGA infants and may be more likely to exhibit complications usually associated with GDM.
最近的证据表明，产前葡萄糖筛查试验异常但无妊娠期糖尿病（GDM）的女性中，婴儿发病率会升高。这些女性处于诊断灰色地带，历来未接受治疗。
48名口服葡萄糖耐量试验结果异常的孕妇，在进行诊断性100克口服葡萄糖耐量试验（OGTT）前1周，每天进行7次自我血糖监测（SMBG）。分娩时，记录围产期并发症和出生体重。OGTT正常的女性的SMBG测试结果与婴儿出生体重相关。
13名婴儿（37%）被发现为大于胎龄儿（LGA）。出生体重增加与空腹SMBG平均数值升高（P <.001）、SMBG数值高于120 mg/dL（6.7 mmol/L）的百分比增加（P <.01）以及SMBG平均数值增加（P <.016）之间存在显著相关性。
诊断灰色地带女性在28周时的母体家庭血糖值与LGA婴儿出生风险相关。空腹SMBG平均数值> 95 mg/dL（5.3 mmol/L）的女性生出LGA婴儿的风险增加，且可能更易出现通常与GDM相关的并发症。
