Casele H L, Laifer S A
Division of Maternal Fetal Medicine, Northwestern University Medical School, Evanston Hospital, Ill 60201, USA.
Arch Intern Med. 1998 Jun 22;158(12):1321-4. doi: 10.1001/archinte.158.12.1321.
Although periconceptional glycemic control directly impacts perinatal outcome for pregestational diabetic women, these women still frequently enter pregnancy with suboptimal control of glycemia.
To determine how frequently diabetic women enter pregnancy with suboptimal glycemic control and to identify factors associated with not achieving optimal periconceptual control of glycemia.
Pregestational diabetic women (n = 55) who attended the Maternal Fetal Medicine Faculty Practice or the Resident Medical Complications Obstetric Clinic, Magee Women's Hospital, Pittsburgh, Pa, were administered a brief questionnaire pertaining to periconceptional education and control of glycemia. Levels of periconceptional hemoglobin A1c, were measured in all patients.
Sixty-one percent of pregestational diabetic women presented for prenatal care with suboptimal control of their blood glucose levels (hemoglobin A1c measurement, >0.08). Of the 55 diabetic women who participated in the questionnaire, 47 (86%) were under the care of a physician for their diabetes, 45 (82%) monitored their glucose level at least 3 times per day, 34 (60%) stated that they had been advised to plan a pregnancy, and 29 (53%) stated that they had planned their pregnancies. Women who had not been advised to achieve target hemoglobin A1c levels were more likely to enter pregnancy with suboptimal control of their blood glucose levels (P = .02). Women who experienced prior complications with pregnancy were significantly more likely to enter pregnancy with suboptimal control of their blood glucose levels (P = .02).
Diabetic women frequently enter pregnancy with suboptimal control of glycemia. Women not advised to achieve target glucose or hemoglobin A1c levels were more likely to enter pregnancy with suboptimal control of glycemia.
尽管孕前血糖控制直接影响孕前糖尿病女性的围产期结局，但这些女性在怀孕时血糖控制仍常常不理想。
确定糖尿病女性怀孕时血糖控制不理想的频率，并识别与未实现孕前血糖最佳控制相关的因素。
对在宾夕法尼亚州匹兹堡市梅杰妇女医院母胎医学系诊所或住院医师医疗并发症产科诊所就诊的孕前糖尿病女性（n = 55）进行了一项关于孕前教育和血糖控制的简短问卷调查。测量了所有患者的孕前糖化血红蛋白水平。
61%的孕前糖尿病女性在进行产前检查时血糖控制不理想（糖化血红蛋白测量值>0.08）。在参与问卷调查的55名糖尿病女性中，47名（86%）因糖尿病接受医生治疗，45名（82%）每天至少监测3次血糖水平，34名（60%）表示曾被建议计划怀孕，29名（53%）表示她们已计划怀孕。未被建议达到糖化血红蛋白目标水平的女性更有可能在怀孕时血糖控制不理想（P = 0.02）。既往有妊娠并发症的女性在怀孕时血糖控制不理想的可能性显著更高（P = 0.02）。
糖尿病女性怀孕时血糖控制常常不理想。未被建议达到血糖或糖化血红蛋白目标水平的女性在怀孕时血糖控制不理想的可能性更大。
