DIABETES IN EARLY PREGNANCY

早孕糖尿病项目是 设计1)检查母亲糖尿病与 在器官发生和后代畸形过程中的控制， 如果可能的话，确定一个或多个特定的致畸因素 糖尿病的代谢状态；以及2)比较早期胎儿损失率 在患有糖尿病的女性和非糖尿病对照组中。我们 研究发现，在以下时期之前进入护理的糖尿病妇女 器官发生的效果要好于晚来的； 但他们的结果仍然比非糖尿病对照组差。 研究对象。孕妇血糖水平的差异 器官发生不能解释子代的畸形 在整个怀孕期间被跟踪的女性。这些 结果表明，进入较晚的女性(且未处于 器官发生过程中的医疗监督)可能很差 控制力。这会导致由于高血糖或 相关因素。糖尿病组早期进入的结果 有力地表明，还有其他致畸机制。 关于早期胎儿丢失，我们发现糖尿病妇女情况良好 代谢控制不会增加自然流产的风险 而不是对照女性；失去的风险随着 糖尿病控制恶化；总体上失去 怀孕率低于预期，仅为16%。因为这些主要的 分析已经完成，一些相关的研究已经完成 已完成(见以前的报告)。抗精子抗体已经被 被证明不是第一次早孕损失的主要因素 (与妊娠后期反复妊娠丢失形成对比)。 这份报告已经发表了。试析二者之间的关系 抗磷脂抗体与妊娠丢失之间的关系 已完成并已提交。尽管这样的抗体已经被 与中期妊娠丢失有关的信息很少 可提供有关早期损失的信息。我们的研究发现两者之间没有联系。 其他正在进行的分析包括对血糖变化的检查 早孕酮水平及其相关因素的描述性研究 对妊娠结局的影响。

The Diabetes in Early Pregnancy Project was designed 1) to examine the relationship between maternal diabetic control during organogenesis and malformations in the offspring, and to identify, if possible, a specific teratogenic factor or factors in the diabetic metabolic state; and 2) to compare early fetal loss rates in women with diabetes and in non-diabetic control subjects. We found that diabetic women who came into care before the period of organogenesis achieved better results than those who came in later; but their results were still poorer than for non-diabetic control subjects. Differences in maternal glucose levels during organogenesis did not explain the malformations in the offspring of the women who were followed throughout pregnancy. These results suggest that women who entered late (and were not under medical supervision during organogenesis) probably had poor control. This resulted in malformations due to hyperglycemia or related factors. The results from the diabetic group entering early strongly suggest that other teratogenic mechanisms were present. Regarding early fetal losses, we found that diabetic women in good metabolic control were at no higher risk for spontaneous abortion than control women; the risk of loss increased dramatically as diabetic control worsened; and the overall risk of losing a pregnancy was lower than expected, only 16%. Since these primary analyses were completed, a number of related studies have been completed (see previous reports). Anti-sperm antibodies have been shown not to be a major factor in first time early pregnancy losses (in contradistinction to recurrent pregnancy loss in later pregnancy). This report has been published. An analysis of the relationship between anti-phospholipid antibodies and pregnancy loss has been completed and submitted. Although such antibodies have been associated with second trimester pregnancy loss, little information is available regarding early loss. Our study found no association. Other ongoing analyses include an examination of glucose changes in early pregnancy and a descriptive study of ketone levels and their effect on pregnancy outcomes.