Rosenn B, Miodovnik M, Combs C A, Khoury J, Siddiqi T A
Department of Obstetrics and Gynecology, University of Cincinnati College of Medicine, Ohio.
Int J Gynaecol Obstet. 1993 Oct;43(1):21-8. doi: 10.1016/0020-7292(93)90269-3.
The purpose of this study was to test the hypothesis that the rate of complications of pregnancy in women with insulin-dependent diabetes is higher than in nondiabetic women and is associated with poor glycemic control and microvascular disease.
Women who enrolled in a multidisciplinary program of diabetes in pregnancy prior to 20 weeks' gestation were included in the study and matched 1:2 by age, race and parity to a control group of nondiabetic women. Complications of pregnancy were retrospectively analyzed and compared between groups. The association of complications with glycemic control and microvascular disease was analyzed within the diabetic group.
Women with diabetes had significantly higher rates of pregnancy-induced hypertension (PIH), polyhydramnios, pyelonephritis, preterm delivery and meconium-stained amniotic fluid. Poor glycemic control, particularly during the first and second trimesters of pregnancy, was associated with all complications, except pyelonephritis. Microvascular disease was associated with PIH and preterm delivery prior to 34 weeks.
Women with insulin-dependent diabetes are at high risk for complications of pregnancy. Glycemic control during the first and second trimesters may affect events later in pregnancy.
本研究旨在验证以下假设，即胰岛素依赖型糖尿病女性的妊娠并发症发生率高于非糖尿病女性，且与血糖控制不佳及微血管疾病相关。
纳入妊娠20周前参加多学科妊娠糖尿病项目的女性，并按年龄、种族和产次1:2匹配非糖尿病女性作为对照组。对两组妊娠并发症进行回顾性分析和比较。在糖尿病组内分析并发症与血糖控制及微血管疾病的关联。
糖尿病女性的妊娠高血压（PIH）、羊水过多、肾盂肾炎、早产和羊水胎粪污染发生率显著更高。血糖控制不佳，尤其是在妊娠的第一和第二孕期，与除肾盂肾炎外的所有并发症相关。微血管疾病与PIH及34周前的早产相关。
胰岛素依赖型糖尿病女性妊娠并发症风险高。妊娠第一和第二孕期的血糖控制可能影响妊娠后期的情况。
