轻度妊娠期高血糖的产科和围产期不良反应:简要综述

N. Sancho-Rodríguez, Martínez-Gascón Le, L. GarcíadeGuadianaRomualdo, J. Martínez-Uriarte, F. Rodríguez-Mulero, Albaladejo-Otón
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引用次数: 1

摘要

妊娠期糖尿病定义为妊娠期间发病的葡萄糖耐受不良,是一种常见病,影响约7-13%的孕妇,具体取决于研究区域。产妇高血糖低于GDM的诊断标准,与各种不良母婴结局的风险增加有关,如剖腹产、先兆子痫、产伤、巨大儿和新生儿低血糖。幸运的是,一些临床医生报告说,控制GDM和低于GDM诊断标准的高血糖可以改善母婴结局。关于葡萄糖激发试验阳性但口服葡萄糖耐量试验阴性孕妇的产科结局的信息很少。本文的目的是提供孕妇可能的产科和围产期并发症与葡萄糖激发试验阳性和阴性或一个异常值的口服葡萄糖耐量试验。方法:进行文献检索以确定出版物。本文分析了采用多变量Cox模型的最新前瞻性研究和病例对照研究,以及本研究考虑的一些最新荟萃分析。结果与结论:本综述提示妊娠相关轻度高血糖主要与巨大儿、妊娠期高血压疾病、羊水过多、新生儿低血糖等孕产妇及围产儿不良结局有关。与治疗妊娠期糖尿病一样,对妊娠期葡萄糖耐受不良的孕妇进行管理可以预防产科和围产期并发症。
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Obstetric and Perinatal Adverse Outcomes of Mild Gestational Hyperglycemia: A Concise Review
Introduction: Gestational diabetes mellitus defined as glucose intolerance with onset during pregnancy, is a common disease affecting approximately 7-13% of pregnant women, depending on the study area. Maternal hyperglycaemia, which is below the diagnostic criteria for GDM, is associated with an increased risk of various adverse maternal and infant outcomes, such as caesarean delivery, preeclampsia, birth injury, macrosomia and neonatal hypoglycemia. Fortunately, several clinicians have reported that managing GDM and hyperglycemia that is below the diagnostic criteria for GDM improves maternal and infant outcomes. There is very little information on obstetrics outcomes of pregnant women with positive Glucose Challenge Test but negative for Oral Glucose Tolerance Test. This paper aims to provide information on possible obstetric and perinatal complications of pregnant women with a glucose challenge test positive and a negative or one abnormal value in oral glucose tolerance test. Methods: A literature search was performed in order to identify publications. The latest prospective and casecontrol studies with multivariate Cox models were analysed, as well as some recent meta-analysis, which were considered for the study. Results and conclusion: The findings shown in this review suggest that mild hyperglycaemia associated to pregnancy is mainly related to maternal and perinatal adverse outcomes as macrosomia, gestational hypertensive disorders, polyhydramnios and neonatal hypoglycaemia. Management of pregnant women with glucose intolerance could prevent obstetric and perinatal complications as in the treatment of gestational diabetes mellitus.
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