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中华产科急救电子杂志 ›› 2023, Vol. 12 ›› Issue (04) : 217 -222. doi: 10.3877/cma.j.issn.2095-3259.2023.04.006

妊娠合并内分泌疾病

妊娠期高血糖诊治进展
黄怡文, 宋青()   
  1. 710065 西安交通大学第一附属医院妇产科
  • 收稿日期:2023-08-06 出版日期:2023-11-18
  • 通信作者: 宋青

Current status of the diagnosis and therapeutics on hyperglycemia in pregnancy

Yiwen Huang, Qing Song()   

  • Received:2023-08-06 Published:2023-11-18
  • Corresponding author: Qing Song
引用本文:

黄怡文, 宋青. 妊娠期高血糖诊治进展[J]. 中华产科急救电子杂志, 2023, 12(04): 217-222.

Yiwen Huang, Qing Song. Current status of the diagnosis and therapeutics on hyperglycemia in pregnancy[J]. Chinese Journal of Obstetric Emergency(Electronic Edition), 2023, 12(04): 217-222.

随着我国糖尿病患者人数的快速增长,以及生育政策调整带来的高龄产妇比例明显升高,妊娠期高血糖已成为最常见的妊娠期并发症。结合国内外近期相关指南及文献,本文介绍了最新的妊娠期高血糖分类、诊断标准,以孕产期时段为导向,依次介绍了妊娠期高血糖孕前、孕期、分娩期及产后的母儿管理,同时提供了相关的预防及随访建议。

With the rapid growth of the number of diabetes mellitus patients, the adjustment of the "comprehensive two-child policy" and "three-child fertility policy" have significantly increased the proportion of elderly pregnant women. Hyperglycemia in pregnancy has become the most common complication of pregnancy. combined with recent domestic and foreign guidelines and literature, this article introduces the classification and diagnostic criteria of hyperglycemia in pregnancy. Then we introduce its maternal and fetal management from four periods: before pregnancy, during pregnancy, perinatal period and postpartum period, and provide relevant prevention and follow-up suggestions.

[1]
中华医学会妇产科学分会产科学组,中华医学会围产医学分会,中国妇幼保健协会妊娠合并糖尿病专业委员会. 妊娠期高血糖诊治指南(2022)[第一部分][J]. 中华妇产科杂志202257(1):3-12.
[2]
中华医学会妇产科学分会产科学组,中华医学会围产医学分会,妊娠合并糖尿病协作组. 妊娠合并糖尿病诊治指南(2014)[J]. 中华妇产科杂志201449(8):561-569.
[3]
ElSayed NA, Aleppo G, Aroda VR, et al. 2. Classification and diagnosis of diabetes: standards of care in diabetes-2023[J]. Diabetes Care202346(Suppl 1):S19-40.
[4]
ElSayed NA, Aleppo G, Aroda VR, et al. 15. Management of diabetes in pregnancy: standards of care in diabetes-2023[J]. Diabetes Care202346(Suppl 1):S254-266.
[5]
中华医学会糖尿病学分会,中国医师协会内分泌代谢科医师分会,中华医学会内分泌学分会等. 中国1型糖尿病诊治指南(2021版)[J]. 中华糖尿病杂志202214(11):1143-1250.
[6]
中华医学会糖尿病学分会. 中国2型糖尿病防治指南(2020版)[J]. 国际内分泌代谢杂志202141(5):482-548.
[7]
中华医学会妇产科学分会产科学组,中华医学会围产医学分会,中国妇幼保健协会妊娠合并糖尿病专业委员会. 妊娠期高血糖诊治指南(2022)[第二部分][J]. 中华妇产科杂志202257(2):81-90.
[8]
Sheng B, Ni J, Lv B, et al. Short-term neonatal outcomes in women with gestational diabetes treated using metformin versus insulin: a systematic review and meta-analysis of randomized controlled trials[J]. Acta Diabetol202360(5):595-608.
[9]
Ornoy A, Becker M, Weinstein-Fudim L, et al. Diabetes during pregnancy: a maternal disease complicating the course of pregnancy with long-term deleterious effects on the offspring. A clinical review[J]. Int J Mol Sci202122(6):1-36.
[10]
Pathirana MM, Ali A, Lassi ZS, et al. Protective influence of breastfeeding on cardiovascular risk factors in women with previous gestational diabetes mellitus and their children: a systematic review and meta-analysis[J]. J Hum Lact202238(3):501-512.
[11]
Jiang L, Tang K, Magee LA, et al. A global view of hypertensive disorders and diabetes mellitus during pregnancy[J]. Nat Rev Endocrinol202218(12):760-775.
[12]
Griffith RJ, Alsweiler J, Moore AE, et al. Interventions to prevent women from developing gestational diabetes mellitus: an overview of cochrane reviews[J]. Cochrane Database Syst Rev20206(6):1-48.
[13]
Altemani AH, Alzaheb RA. The prevention of gestational diabetes mellitus (the role of lifestyle): a meta-analysis[J]. Diabetol Metab Syndr202214(1):1-11.
[14]
Association AD. 10. Cardiovascular disease and risk management: standards of medical care in diabetes-2020[J]. Diabetes Care202043(Suppl 1):S111-134.
[15]
Guasch-Ferre M, Willett WC. The mediterranean diet and health: a comprehensive overview[J]. J Intern Med2021290(3):549-566.
[16]
van Poppel M, Damm P, Mathiesen ER, et al. Is the biphasic effect of diabetes and obesity on fetal growth a risk factor for childhood obesity?[J]. Diabetes Care202346(6):1124-1131.
[17]
Zeng J, Shen F, Zou ZY, et al. Association of maternal obesity and gestational diabetes mellitus with overweight/obesity and fatty liver risk in offspring[J]. World J Gastroenterol202228(16):1681-1691.
[18]
Eletri L, Mitanchez D. How do the different types of maternal diabetes during pregnancy influence offspring outcomes?[J]. Nutrients202214(18):1-19.
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