2004-2017 年女性 1 型糖尿病患者妊娠结局的时间趋势。
Time trends in pregnancy-related outcomes among women with type 1 diabetes mellitus, 2004-2017.
机构信息
Harvard Medical School, Boston, MA, USA.
Department of Environmental health, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
出版信息
J Perinatol. 2020 Aug;40(8):1145-1153. doi: 10.1038/s41372-020-0698-x. Epub 2020 Jun 2.
OBJECTIVE
To examine time trends in US pregnant women with type 1 diabetes mellitus for maternal characteristics and pregnancy outcomes.
STUDY DESIGN
We abstracted clinical data from the medical records of 700 pregnant women from 2004 to 2017. For each time period, means and percentages were calculated. P values for trend were calculated using linear and logistic regression.
RESULTS
HbA1c in each trimester was unchanged across the analysis period. The prevalence of nephropathy decreased from 4.8% to 0% (P = 0.002). Excessive gestational weight gain increased (P = 0.01). Gestation length also increased (P = 0.01), as did vaginal deliveries (P = 0.03). There were no change in birthweight over time (P = 0.07) and the percentage of neonates with macrosomia and large for gestational age (LGA) neonates also remained unchanged.
CONCLUSION
Obstetric guideline changes may have improved gestation length and mode of delivery; however, other outcomes need more attention, including excessive gestational weight gain, macrosomia, and LGA.
目的
研究美国 1 型糖尿病孕妇的母体特征和妊娠结局随时间的变化趋势。
研究设计
我们从 2004 年至 2017 年的 700 名孕妇的病历中提取临床数据。对于每个时间段，计算平均值和百分比。使用线性和逻辑回归计算趋势的 P 值。
结果
整个分析期间，每个孕期的 HbA1c 均无变化。肾病的患病率从 4.8%降至 0%（P=0.002）。过度的妊娠期体重增加（P=0.01）。妊娠时间也延长（P=0.01），阴道分娩也增加（P=0.03）。出生体重随时间无变化（P=0.07），巨大儿和大于胎龄儿（LGA）新生儿的比例也保持不变。
结论
产科指南的变化可能改善了妊娠时间和分娩方式；然而，还需要更多关注其他结果，包括过度的妊娠期体重增加、巨大儿和 LGA。
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