Placental structural abnormalities in gestational diabetes and when they develop: A scoping review.
Placental structural abnormalities in gestational diabetes and when they develop: A scoping review.
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DOI：
10.1016/j.placenta.2021.04.005
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发表时间：
2021-12
期刊：
影响因子：
3.8
通讯作者：
Schulz, Laura C.
中科院分区：
文献类型：
--
作者：
Ehlers, Erin;Talton, Omonseigho O.;Schust, Danny J.;Schulz, Laura C.
妊娠期糖尿病（GDM）是指妊娠期发病或首次发现的糖尿病.这是一种常见的妊娠并发症，在过去几十年中变得更加普遍。胎儿生长异常，包括大于胎龄儿和小于胎龄儿的发生率增加，提示胎盘功能障碍。本次范围审查的主要目标是确定什么是已知的异常胎盘交付GDM妊娠，以及如何在妊娠早期出现这些异常。第二个目标是审查在何种程度上其他选定的因素，特别是肥胖，已发现影响或修改报告的影响GDM胎盘发育，以及这些是否被认为是在研究GDM胎盘。使用关键词检索PubMed和Scopus数据库：“妊娠期糖尿病和（女性或人类）和胎盘和（超声或超微结构或成像或组织学或病理学）。GDM妊娠分娩胎盘的大体形态学和组织结构研究一致报告，与无并发症妊娠相比，胎盘大小增加，绒毛不成熟和一系列血管病变。相反，少数超声研究检查了妊娠期糖尿病妊娠的胎盘发育，尤其是妊娠早期。相对较少的研究分析了与母体BMI的相互作用，但这些确实表明它可能在胎盘异常中发挥作用。需要在妊娠早期对胎盘发育进行进一步检查，以了解GDM中胎盘发育何时被破坏，这是确定潜在原因的第一步。
Gestational diabetes mellitus (GDM) is defined as diabetes with onset or first recognition during gestation. It is a common complication of pregnancy that has become more prevalent over the past few decades. Abnormalities in fetal growth, including increased incidence of both large and small for gestational age babies, suggest placental dysfunction. The major goal of this scoping review is to determine what is known about abnormalities in placentas delivered from GDM pregnancies, and how early in gestation these abnormalities arise. A secondary goal is to review to what extent other selected factors, particular obesity, have been found to influence or modify the reported effects of GDM on placental development, and whether these are considered in the study of GDM placentas. PubMed and Scopus databases were searched using the key terms: “gestational diabetes AND (woman OR human) AND placenta AND (ultrasound OR ultrastructure OR imaging OR histology OR pathology). Studies of gross morphology and histoarchitecture in placentas delivered from GDM pregnancies consistently report increased placental size, villous immaturity and a range of vascular lesions when compared to uncomplicated pregnancies. In contrast, a small number of ultrasound studies have examined placental development in GDM pregnancies in the second, and especially, the first trimester. Relatively few studies have analyzed interactions with maternal BMI, but these do suggest that it may play a role in placental abnormalities. Further examination of placental development early in pregnancy is needed to understand when it becomes disrupted in GDM, as a first step to identifying the underlying causes.
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