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Diabetes Care: 2型糖尿病青少年女性患者不宜妊娠,患病期间后代出生缺陷比例高(TODAY研究)

2015-12-04 MedSci译 MedSci原创

尽管糖尿病特异信息推荐控制生育和避免妊娠,研究中仍有10%的受试者怀孕。2型糖尿病青少年患者怀孕,可能特别容易产出先天性畸形婴儿。2型糖尿病青少年患者怀孕产出先天性畸形婴儿比例较高的原因尚不清楚,但可能包括代谢控制较差和严重肥胖。 1.Birth Defect Rates High in Youth-Onset Type 2 Diabetes Pregnancies.Medscap

目标: 青少年和青年2型糖尿病的治疗方案研究(TODAY研究)评估妊娠结局、孕产妇和胎儿或新生儿状况。
 
设计和方法:  TODAY研究是一个随机对照试验,比较青少年起病2型糖尿病患者的三种治疗方法。知情同意包括避孕、禁欲,在每次随访时都告知受试者。知情同意后,回顾性收集母亲产前和分娩期和婴儿健康数据。得到受试者知情同意后,综合分析孕产妇医疗记录和婴儿出生记录。
 
结果: 研究共纳入452名女性受试者,其中有46例(10.2%)女性受试者共妊娠63次。尽管持续强调要采取足够的避孕措施,只有4.8%的孕妇报告妊娠前使用避孕措施。受试者第一次怀孕的平均年龄为18.4岁,平均糖尿病患病时间为3.17年。
 
7例妊娠受试者选择性终止参与试验,3例妊娠数据丢失。共有53例妊娠数据可用,其中5例(9.4%)受试者妊娠早期流产,7例(13%)受试者妊娠时间数据不能提供。两例妊娠最终分别在27周和37周死产,39例产妇产出活产婴儿。39例活产婴儿中6例(15.4%)是早产儿,8例(20.5%)有重大先天性异常。
 
结论: 尽管糖尿病特异信息推荐控制生育和避免妊娠,研究中仍有10%的受试者怀孕。2型糖尿病青少年患者怀孕,可能特别容易产出先天性畸形婴儿。2型糖尿病青少年患者怀孕产出先天性畸形婴儿比例较高的原因尚不清楚,但可能包括代谢控制较差和严重肥胖。
 
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    2016-01-04 xyfg98

    0

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    2015-12-27 hixiaoluo

    好文章,值得收藏

    0

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    2015-12-27 hixiaoluo

    好文章,值得收藏

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