Piper J M, Field N T, Higby K, Elliott B D, Langer O
Department of Obstetrics and Gynecology, University of Texas Health Science Center at San Antonio, USA.
J Reprod Med. 1996 Oct;41(10):761-6.
To test the hypothesis that in normotensive pregnancies decreased maternal glucose response leads to relative fetal hypoglycemia and hypoinsulinemia, which result in delayed fetal growth.
We enrolled patients with and without risk factors for growth retardation. Each underwent an oral glucose tolerance test with both glucose and insulin evaluation. Cord blood was obtained for glucose and insulin evaluation.
The normotensive pregnancies at risk had lower maternal glucose levels (index, 91 vs. 116 mg/dL; P < .05), a trend toward lower maternal insulin levels (index, 398 vs. 483 muIU/mL; P = NS) and normal maternal insulin/glucose ratios. We found no differences, however, in the fetal metabolic parameters (glucose 83 vs. 78 mg/dL, insulin 17 vs. 24 muIU/mL; P = NS).
Maternal glucose metabolism is altered in nonhypertensive pregnancies, with a risk of delayed fetal growth; however, the fetal glucose response may remain normal in the face of fetal growth retardation.
检验以下假设，即在血压正常的妊娠中，母体葡萄糖反应降低会导致相对的胎儿低血糖和低胰岛素血症，进而导致胎儿生长迟缓。
我们纳入了有和没有生长迟缓风险因素的患者。每位患者都接受了口服葡萄糖耐量试验，并评估了葡萄糖和胰岛素水平。采集脐带血用于评估葡萄糖和胰岛素水平。
有风险的血压正常妊娠的母体葡萄糖水平较低（指数分别为91和116mg/dL；P<.05），母体胰岛素水平有降低趋势（指数分别为398和483mU/mL；P=无显著性差异），且母体胰岛素/葡萄糖比值正常。然而，我们发现胎儿代谢参数并无差异（葡萄糖分别为83和78mg/dL，胰岛素分别为17和24mU/mL；P=无显著性差异）。
在非高血压妊娠中，母体葡萄糖代谢发生改变，存在胎儿生长迟缓的风险；然而，面对胎儿生长迟缓，胎儿的葡萄糖反应可能仍保持正常。
