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妊娠期母体血糖水平与妊娠结局的共识和争议 被引量：4

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摘要 妊娠期糖尿病(gestational diabetes mellitus,GDM)是指在妊娠期发生或首次发现的不同程度的糖耐量异常[1],是妊娠期最常见的并发症之一.该定义包括了妊娠前已存在的糖代谢异常而在妊娠时首次被诊断以及产后仍持续存在糖耐量异常的妇女.据世界各国文献报道,GDM的发病率约为1％～14％,因种族差异和诊断标准的不同相差悬殊,并且该比例呈上升趋势[2].近年来,在西方国家多种族社会中,亚裔妇女的发病率为1.6％ ～11.9％,较其他种族高2～3倍[3-4].最近一项高血糖与不良妊娠结局关系的研究(the Hyperglycemia and Adverse Pregnancy Outcomes study,HAPO)结果显示,即使孕妇血糖水平在诊断显性糖尿病以下范围内变化亦与不良妊娠结局的发生呈连续线性相关[5].基于此项结果,国际妊娠合并糖尿病研究组(International Association of Diabetic Pregnancy Study Group,IADPSG)组织全球专家制定了新的GDM诊断模式和标准,2011年美国糖尿病协会(American Diabetes Association,ADA)亦建议采用IADPSG标准作为GDM的诊断标准[6].
作者 易晓云 马润玫 陈卓
机构地区 昆明医科大学第一附属医院妇产科
出处 《中华临床医师杂志（电子版）》 CAS 2012年第18期128-130,共3页 Chinese Journal of Clinicians(Electronic Edition)
基金 云南省科学技术厅社会发展科技计划(社会事业发展专项)(2009CA006)
关键词 妊娠结局 孕妇 血糖水平 GDM 新生儿出生体重 妊娠期
分类号 R714.256 [医药卫生—妇产科学]
  • 相关文献

参考文献32

  • 1Metzger BE,Coustan DR. Summary and recommendations of the Fourth International Workshop-Conference on Gestational Diabetes Mellitus.The Organizing Committee[J].Diabetes Care,1998.B161-B167.
  • 2American Diabetes Association. Diagnosis and classification of diabetes mellitus[J].Diabetes Care,2007.S42-S47.
  • 3Pedula KL,Hillier TA,Schmidt MM. Ethnic differences in gestational oral glucose screening in a large US population[J].Ethnicity and Disease,2009.414-419.
  • 4Hedderson MM,Darbinian JA,Ferrara A. Disparities in the risk of gestational diabetes by race-ethnicity and country of birth[J].Pediatric and Perinatal Epidemiology,2010.441-448.
  • 5The HAPO Study Cooperative Research Group,Metzger BE,Lowe LP. Hyperglycemia and adverse pregnancy outcomes[J].New England Journal of Medicine,2008.1991-2002.
  • 6American Diabetes Association. Diagnosis and classification of diabetes mellitus[J].Diabetes Care,2011.S62-S69.
  • 7Bellamy L,Casas JP,Hingorani AD. Type 2 diabetes mellitus after gestational diabetes:a systematic review and meta-analysis[J].Lancet,2009.1773-1779.
  • 8Burguet A. Long-term outcome in children of mothers with gestational diabetes[J].Diabetes & Metabolism,2010.682-694.
  • 9Riskin-Mashiah S,Damti A,Younes G. First trimester fasting hyperglycemia as a predictor for the development of gestational diabetes mellitus[J].European Journal of Obstetrics & Gynecology and Reproductive Biology,2010.163-167.
  • 10Siegmund T,Rad NT,Ritterath C. Longitudinal changes in the continuous glucose profile measured by the CGMS in healthy pregnant women and determination of cut-off values[J].European Journal of Obstetrics & Gynecology and Reproductive Biology,2008.46-52.

二级参考文献25

  • 1American Diabetes Association. Gestational diabetes mellitus. Diabetes Care, 2004, 27: 88-90.
  • 2Langer O, Yogev Y, Most O, et al. Gestational diabetes: the consequences of not treating. Am J Obstet Gynecol, 2005,192 : 959 -997.
  • 3Fan ZT, Gao XL, Yang HX. Popularizing labor analgesia in China. Int J Gynecol Obstet,2007 ,98 :205-207.
  • 4Crowther CA, Hiller JE, Moss JR, et al. Effect of treatment of gestational diabetes mellitus on pregnancy outcomes. N Engl J Med,2005,352 : 2477 -2486.
  • 5Landon MB, Spong CY, Thom E, et al. A muhicenter, randomized trial of treatment for mild gestational diabetes. N Engl J Med,2009,361 : 1339-1348.
  • 6American Diabetes Association. Standards of medical care in diabetes-2010. Diabetes Care ,2010,33 : 11-61.
  • 7Hadar E, Oats J, Hod M. Towards new diagnostic criteria for diagnosing GDM: the HAPO study. J Perinat Med,2009 ,37 :447- 449.
  • 8American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care,2011,34:62-69.
  • 9International Association of Diabetes and Pregnancy Study Groups Consensus Panel, Metzger BE, Gabbe SG, et al. International association of diabetes and pregnancy study groups recommendations on the diagnosis and classification of hyperglycemia in pregnancy. Diabetes Care ,2010,33:676-682.
  • 10HAPO Study Cooperative Research Group, Metzger BE, Lowe LP, et al. Hyperglycemia and adverse pregnancy outcomes. N En~l J Med .2008.358 : 1991-2002.

共引文献149

同被引文献76

  • 1陈月明.护理干预对妊娠期糖尿病妊娠结局的影响[J].医药前沿,2012,2(16) :265.
  • 2潘燕飞.正常糖耐量孕妇不同血糖水平与妊娠结局的关系[D].广州:南方医科大学,2012:13-21.
  • 3乐杰.妇产科学[M]北京:人民卫生出版社,200862.
  • 4Pedula KI,Hillier TA,Schmidt MM. Ethnic differences in gestational oral glucose screening in a large US population[J].Ethnicity and Disease,2009,(04):414-419.
  • 5Kerenyi Z,Tamas G,Kivimaiiki M. Matemal glycemia and risk of large-for-gestational-age babise in a population-based screening[J].DIABETES CARE,2009,(12):2200-2205.
  • 6Landon MB,Mele L,Spong CY. The relationship between maternal glycemia and perinatal outcome[J].Obstetrics & Gynecology,2011,(02):218-224.
  • 7Landon MB,Spong CY,Thom E. A Multicenter,Randomized Trial of Treatment for Mild Gestational Diabetes[J].New England Journal of Medicine,2009,(01):1339-1348.
  • 8吴俐红,徐丽琴.中西医结合小群体健康教育在妊娠期糖尿病的应用[J].中国实用护理杂志,2013,29(14):161.
  • 9Higgins JP,Green S.Cochrane Handbook for Systematic Reviews ofInterventions Version 5.1.0[J].The Cochrane Collaboration,2011,63:301-311.
  • 10黄淑婷,张昌婷,伍允烧,等.护理干预对妊娠期糖屎病的临床影响观察[J].中国保健营养,2013,23(7):63.

引证文献4

二级引证文献131

中华临床医师杂志（电子版）
2012年 第18期

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