Omori Y, Minei S, Testuo T, Nemoto K, Shimizu M, Sanaka M
Diabetes Res Clin Pract. 1994 Oct;24 Suppl:S273-8. doi: 10.1016/0168-8227(94)90261-5.
Pregnancy in diabetic patients was uncommon before 1960 in Japan. It has increased recently and there has been a 3-fold increase since 1971. Only 26% of the cases of diabetic pregnancy had IDDM; the rest of cases had NIDDM. The perinatal mortality of infants decreased from 10.8% in 1971-1975 to 1.1% in 1986-1990, but the incidence of congenital malformations remained at 5.7-8.2% during this period. From 1988 to 1992, we experienced 207 deliveries at the Diabetes Center, Tokyo Women's Medical College. The ratio of IDDM to NIDDM of the mothers was 33:67. The onset of diabetes of pregnant women occurred earlier and the duration of diabetes was longer in IDDM than in NIDDM (mean onset, 17.8 vs. 26.0 years; mean duration, 11.5 vs. 5.6 years). The prevalence of maternal complications was similar between the IDDM and NIDDM mothers. Proliferative retinopathy in NIDDM was often detected for the first time during pregnancy. Major congenital malformations were found in none of the infants of IDDM mothers but in 5.8% of the infants of NIDDM mothers. This is probably related to the poor management of diabetes in NIDDM before pregnancy.
1960年以前，糖尿病患者怀孕在日本并不常见。近年来这一情况有所增加，自1971年以来增长了3倍。糖尿病合并妊娠的病例中，仅26%为胰岛素依赖型糖尿病（IDDM）；其余病例为非胰岛素依赖型糖尿病（NIDDM）。围产儿死亡率从1971 - 1975年的10.8%降至1986 - 1990年的1.1%，但在此期间先天性畸形的发生率仍维持在5.7 - 8.2%。1988年至1992年，我们在东京女子医科大学糖尿病中心经历了207例分娩。母亲中IDDM与NIDDM的比例为33:67。IDDM孕妇糖尿病的发病时间早于NIDDM，且糖尿病病程更长（平均发病年龄，17.8岁对26.0岁；平均病程，11.5年对5.6年）。IDDM和NIDDM母亲的母体并发症患病率相似。NIDDM患者的增殖性视网膜病变常在孕期首次被发现。IDDM母亲的婴儿中未发现严重先天性畸形，而NIDDM母亲的婴儿中有5.8%出现严重先天性畸形。这可能与妊娠前NIDDM患者糖尿病管理不善有关。
