早孕期孕妇糖化血红蛋白水平与胎儿畸形的关系

Elevated maternal hemoglobin A1c in early pregnancy and major congenital anomalies in offspring of diabetic mothers

目的探讨早孕期孕妇糖化血红蛋白（GHb）水平与胎儿畸形的关系。方法以来我院早孕门诊孕周小于16w，有糖尿病家族史或糖尿病史的孕妇126例为对象，用高效液相色谱仪（HPLC）测定HbAlc，孕20～24w进行彩色B超检查。B超未发现异常的胎儿继续妊娠，追踪观察至胎儿娩出，分析HbAlc水平与胎儿畸形的相关性。结果早孕期HbAlc水平大于11％时，胎儿畸形发生率明显升高。

Objective： To evaluate hemoglobin A1 c （HbAlc） for predicting congenital abnormalities in overt diabetic pregnancies. Methods： Overt diabetic gravidas with initial hemoglobin A1 c （ HbA1 c） above 6. 5%, or a family history of congenital heart disease were referred to detailed fetal sonography and follow -up. Totally, 126 patients received care in the diabetes and pregnancy service . Results： An initial HbAlc above 11% was highly associated with fetal abnormalities. Conclusions： Among patients with abnormal HbAlc values, detailed fetal examination was recommended.