THE RELATIONSHIP BETWEEN LARGE-FOR-GESTATIONAL-AGE INFANTS AND GLYCEMIC CONTROL IN WOMEN WITH GESTATIONAL DIABETES
THE RELATIONSHIP BETWEEN LARGE-FOR-GESTATIONAL-AGE INFANTS AND GLYCEMIC CONTROL IN WOMEN WITH GESTATIONAL DIABETES
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DOI：
10.1016/0002-9378(88)90578-9
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发表时间：
1988-12-01
影响因子：
9.8
通讯作者：
MAZZE, R
中科院分区：
文献类型：
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作者：
LANGER, O;MAZZE, R
在这项前瞻性研究中，对 246 名患有妊娠糖尿病的女性进行了随访，以确定与大于胎龄儿相关的代谢控制特征。基于记忆的反射计用于自我监测血糖。生成动态血糖曲线来表征整个怀孕期间的血糖控制水平。通过这些收集和表示葡萄糖数据的新方法，发现葡萄糖不耐受（高血糖）的严重程度与婴儿体型和剖宫产率方面的孕产妇和新生儿发病率相关。通过使用分层聚类分析根据对照水平（低 105 mg/dl）识别三组，我们能够在低组中显示出积极的结果，其中大于胎龄儿（2%）和巨大儿（0%）的比率降低。此外，我们发现，随着各组平均血糖水平和血糖控制不稳定性的增加，大于胎龄儿和巨大儿的发生率也会增加。尽管肥胖增加了新生儿不良结局的相对风险，但治疗类型（胰岛素与饮食）似乎并不显着。适当监测妊娠期动态血糖在狭窄范围内的稳定性以实现严格的代谢控制，可降低母婴并发症的风险。
In this prospective study 246 women with gestational diabetes were followed up to determine the characteristics of metabolic control associated with large-for-gestational-age infants. Memory-based reflectance meters were used for self-monitoring blood glucose. Ambulatory glucose profiles were produced to characterize glycemic control levels throughout pregnancy. With these novel approaches to the collection and representation of glucose data, the severity of glucose intolerance (hyperglycemia) was found to be associated with both maternal and neonatal morbidity in terms of infant size and cesarean section rate. By use of hierachical cluster analysis to identity three groups on the basis of control levels (low 105 mg/dl) we were able to show a positive outcome in the low group with reduced rates of large-for-gestational-age (2%) and macrosomatic (0%) infants. Furthermore, we showed that as mean blood glucose levels and instability in glycemic control increased from group to group, incidence of large-for-gestational-age and macrosomatic infants increased. Whereas obesity increased the relative risk of adverse neonatal outcome, type of treatment (insulin versus diet) did not appear to be significant. Appropriately monitored toward stability within a narrow range to achieve tight metabolic control, ambulatory glycemia in pregnancy is associated with a decreased risk of maternal and fetal complications.