从怀孕前,怀孕期间和之后的病理生理学
Marie-France Hivert1, Helena Backman2, Katrien Benhalima3
1Division of Chronic Disease Research Across the Lifecourse (CoRAL), Department of Population Medicine, Harvard Medical School, Harvard Pilgrim Health Care Institute, Boston, MA, USA; Diabetes Unit, Massachusetts General Hospital, Boston, MA, USA.
Lancet (London, England)
|June 23, 2024
概括
孕期糖尿病是最常见的妊娠并发症, 了解它的亚型和早期代谢变化是预防母亲和婴儿并发症的关键.
科学领域:
- 产科和妇科
- 内分泌学
- 产周医学
背景情况:
- 孕期糖尿病 (GDM) 是怀孕期间最常见的医学并发症.
- 从历史上看,GDM管理主要集中在第二季度末的血糖控制上.
- 新出现的证据强调了妊娠前和妊娠特异性因素,包括非血糖作用,对GDM病因和结果的影响.
研究的目的:
- 挑战怀孕期糖尿病的传统观点.
- 根据时间和病理生理学来探索GDM的异质性.
- 研究早期代谢干扰对母亲和胎儿发育的影响.
主要方法:
- 关于妊娠糖尿病病理生理学的最新证据的审查.
- 影响妊娠血糖的因素分析.
- 在怀孕早期和晚期检查胰岛素分泌和抵抗模式.
主要成果:
- 孕期糖尿病呈现异质性,具有明显的早期和胰岛素抵抗性亚型.
- 早期的GDM代谢变化可能会损害胎盘发育并影响胎儿生长.
- 特定的GDM亚型与妊娠并发症的风险增加有关.
结论:
- 更深入地了解GDM病理生理学和异质性至关重要.
- 需要新的管理策略来预防母亲和后代的短期和长期并发症.
- 干预措施应涵盖怀孕前,怀孕后和分娩后的时间.
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