Gabbe S G, Mestman J G, Freeman R K, Anderson G V, Lowensohn R I
Am J Obstet Gynecol. 1977 Mar 1;127(5):465-9. doi: 10.1016/0002-9378(77)90436-7.
Patients who have a normal fasting serum glucose (FSG) and an abnormal glucose tolerance test, and who require little dietary regulation, have been designated as Class A diabetics by White. During the period 1970 through 1972, 261 Class A women were delivered at Los Angeles County (LAC) Women's Hospital. These patients were managed by a uniform protocol which included dietary supervision and continued surveillance for the onset of overt diabetes. Elective intervention prior to 40 weeks' gestation was to be avoided. Twenty-five per cent of the Class A patients--those who had had a previous stillbirth or who developed pre-clampsia--were considered at greater risk for perinatal death and were managed as if they had overt diabetes. The perinatal death rate for the entire Class A group was 19/1,000 as compared to 32/1,000 in the general population. Five perinatal deaths occurred, three associated with congenital malformations. There were no unexplained stillbirths or deaths due to trauma or iatrogenic prematurity. Our data thus indicate that as long as the FSG remains normal, an unexplained intrauterine death is a rare event. Twenty-five per cent of the infants did experience some morbidity.
空腹血清葡萄糖（FSG）正常但葡萄糖耐量试验异常、且只需少量饮食调节的患者，被怀特归类为A类糖尿病患者。在1970年至1972年期间，261名A类女性在洛杉矶县（LAC）妇女医院分娩。这些患者按照统一方案进行管理，该方案包括饮食监督和对显性糖尿病发病情况的持续监测。避免在妊娠40周前进行选择性干预。25%的A类患者——那些曾有过死产史或发生过先兆子痫的患者——被认为围产期死亡风险更高，并按照患有显性糖尿病的患者进行管理。整个A类患者组的围产期死亡率为19‰，而普通人群为32‰。发生了5例围产期死亡，其中3例与先天性畸形有关。没有不明原因的死产或因创伤或医源性早产导致的死亡。因此，我们的数据表明，只要FSG保持正常，不明原因的宫内死亡就是罕见事件。25%的婴儿确实出现了一些发病情况。
