HYPERGLYCEMIA AND ADVERSE PREGNANCY OUTCOME STUDY (HAPO)

高血糖和不良妊娠结局研究 (HAPO)

• 批准号: 7376818
• 负责人: SHARON DOOLEY
• 金额: $ 0.04万
• 依托单位: NORTHWESTERN UNIVERSITY AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-12-01 至 2006-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7376818
• 关键词: HYPERGLYCEMIA; ADVERSE; PREGNANCY; OUTCOME; STUDY

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. There is a consensus that during pregnancy, overt diabetes mellitus (DM), whether or not accompanied by symptoms or signs of metabolic decompensation, is associated with a significant risk of adverse outcome. However, the risk of adverse perinatal outcome associated with degrees of maternal glucose intolerance less severe than overt DM is controversial. We hypothesize that hyperglycemia, less severe than overt DM, is associated with increased risk of adverse maternal, fetal and neonatal outcome that is independently related to the degree of metabolic disturbance. To address this hypothesis, we propose participation in a large, multinational collaborative study, with the following specific aims: 1) to examine glucose tolerance in a large, heterogeneous, multinational, multicultural, ethnically diverse cohort of women in the third trimester of gestation with medical caregivers "blinded" to status of glucose tolerance (except when predefined criteria are met) with collaborating investigators from sixteen centers around the world using a common protocol and data collection instruments, uniformly established training of personnel, and a central laboratory for analyses; and 2) to provide data on specific relationships between maternal glycemia and risk of specific adverse outcomes that can be used to derive internationally acceptable criteria for the diagnosis and classification of gestational diabetes mellitus (GDM). The primary outcomes of interest are those most strongly associated with the maternal metabolic disturbances of overt diabetes mellitus, specifically: fetal hyperinsulinism (cord blood c-peptide); fetal obesity (macrosomia as defined by excessive birth weight for length); cesarean delivery; shoulder dystocia; and neonatal hypoglycemia.

该子项目是利用NIH/NCRR资助的中心赠款提供的资源的许多研究子项目之一。子项目和研究者（PI）可能从另一个NIH来源获得了主要资金，因此可以在其他CRISP条目中表示。所列机构为中心，不一定是研究者所在机构。有一个共识，在怀孕期间，显性糖尿病（DM），无论是否伴有代谢失代偿的症状或体征，与不良后果的重大风险。然而，围产期不良结局的风险与母亲葡萄糖耐受不良程度的严重程度低于显性糖尿病是有争议的。我们推测，高血糖症，不太严重的显性糖尿病，是与风险增加的不利的母亲，胎儿和新生儿的结果是独立相关的代谢紊乱的程度。为了解决这一假设，我们建议参与一项大型跨国合作研究，具体目标如下：1）在一个大型的、异质的、多国的、多文化的、不同种族的妊娠晚期妇女队列，医疗护理人员对葡萄糖耐量状态“不知情”（除非符合预定义的标准）与来自世界各地16个中心的合作研究者使用共同的方案和数据收集工具、统一建立的人员培训和中心实验室进行分析;和2）提供关于母体妊娠与特定不良结果风险之间的特定关系的数据，这些数据可用于推导妊娠期糖尿病（GDM）诊断和分类的国际可接受标准。关注的主要结局是那些与显性糖尿病的母体代谢紊乱最密切相关的结局，特别是：胎儿高胰岛素血症（脐带血C肽）;胎儿肥胖（巨大儿，定义为出生体重超过身长）;剖宫产;肩难产;新生儿低血糖。