Thompson D M, Dansereau J, Creed M, Ridell L
Department of Medicine, University of British Columbia, Vancouver, Canada.
Obstet Gynecol. 1994 Mar;83(3):362-6.
To determine whether tight control of blood glucose is associated with normal outcomes in gestational diabetes.
We studied 150 consecutive patients with gestational diabetes referred to a diabetes in pregnancy clinic. Selection criteria were an abnormal glucose tolerance test, diabetic management by one physician, capillary blood glucose monitoring in the prenatal period, and delivery at Grace Hospital. Degree of glucose control during pregnancy and maternal and perinatal outcomes were determined by chart review.
Overall average glucose levels were 4.9 mmol/L (89 mg/dL) before meals and 6.7 mmol/L (122 mg/dL) 1 hour after meals. Thirty-one percent of the patients were treated with insulin in the prenatal period. In this series, there was no perinatal mortality and no increased incidence of large or small for gestational age infants, cesarean delivery, preterm labor, pregnancy-induced hypertension, neonatal respiratory distress, hypoglycemia, polycythemia, symptomatic hyperbilirubinemia, symptomatic hypocalcemia, or congenital malformations.
Tight glucose control is associated with normal perinatal outcome in gestational diabetes.
确定严格控制血糖是否与妊娠期糖尿病的正常结局相关。
我们研究了连续转诊至妊娠糖尿病诊所的150例妊娠期糖尿病患者。入选标准为葡萄糖耐量试验异常、由一名医生进行糖尿病管理、孕期进行毛细血管血糖监测以及在格蕾丝医院分娩。通过查阅病历确定孕期血糖控制程度以及母婴和围产期结局。
总体平均血糖水平为餐前4.9毫摩尔/升(89毫克/分升),餐后1小时6.7毫摩尔/升(122毫克/分升)。31%的患者在孕期接受了胰岛素治疗。在该系列研究中,无围产期死亡,且适于胎龄儿、大于胎龄儿、剖宫产、早产、妊娠高血压、新生儿呼吸窘迫、低血糖、红细胞增多症、症状性高胆红素血症、症状性低钙血症或先天性畸形的发生率均未增加。
严格的血糖控制与妊娠期糖尿病的正常围产期结局相关。