Maternal glucose concentration influences fetal growth, gestation, and pregnancy complications
Maternal glucose concentration influences fetal growth, gestation, and pregnancy complications
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DOI：
10.1093/aje/154.6.514
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发表时间：
2001-09-15
影响因子：
5
通讯作者：
Lenders, C
中科院分区：
文献类型：
--
作者：
Scholl, TO;Sowers, M;Lenders, C
作者使用1990-1995年的数据，在1,157名非糖尿病的美国孕妇中研究了激发后母体葡萄糖浓度对妊娠结局的影响。在控制了潜在的混杂变量并比较了血糖浓度较低（分别为130 mg/dl）的孕妇后，母体葡萄糖浓度升高也与妊娠期胎儿过大的风险增加（趋势p < 0.001）和胎儿生长受限的风险降低（趋势p < 0.05）相关。当血糖浓度较高时，血糖和妊娠之间的关系是相反的，并显着缩短。产妇并发症增加两倍或更多的高血糖浓度，包括剖宫产和临床绒毛膜炎。绒毛膜炎与高母体血糖浓度相结合使极早产的风险增加近12倍。这些观察结果扩展了Pedersen的假设，即高浓度的母体葡萄糖引起向胎儿转移的营养增加并促进胎儿生长，超出了母体糖尿病的模型（Acta Endocrinol 1954;16：330-42）。他们提出了一个问题，即较高但看似正常的母体葡萄糖浓度是否易患胎盘炎症和感染，或者是胎盘炎症和感染的标志物。
Using 1990-1995 data, the authors examined the influence of post-challenge maternal glucose concentration on pregnancy outcome in 1,157 nondiabetic US gravidas. After control for potential confounding variables and comparing gravidas with lower glucose concentrations (130 mg/dl, respectively. increased maternal glucose concentration also was associated with an increased risk of large-for-gestation fetuses (p for trend < 0.001) and a decreased risk of fetal growth restriction (p for trend < 0.05). The association between glucose and gestation was inverse and significantly shortened when glucose concentrations were higher. Maternal complications increased twofold or more with high glucose concentrations and included cesarean section and clinical chorioamnionitis. Chorioamnionitis in combination with high maternal glucose concentration increased the risk of very preterm delivery almost 12-fold. These observations extend Pedersen's hypothesis-that high concentrations of maternal glucose give rise to increased nutrient transfer to the fetus and increase fetal growth, beyond the model of maternal diabetes (Acta Endocrinol 1954;16:330-42). They raise the question of whether higher, but seemingly normal maternal glucose concentration predisposes to or is a marker for placental inflammation and infection.