糖尿病酸性脂肪酸症后的怀孕结果:一个系统性审查
Gabriella D Cozzi-Glaser1, Allison M Davis2, Megan Bell3
1Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, IL (Cozzi-Glaser).
American journal of obstetrics & gynecology MFM
|May 30, 2025
概括
糖尿病糖尿病酸症 (DKA) 后的怀孕结果仍然很差,死产,剖腹产和早产的比例很高. 虽然死产率可能正在下降,但需要更多关于怀孕中DKA管理的研究.
科学领域:
- 产科和妇科 产科和妇科
- 内分泌学 在内分泌学.
- 新生儿医学 新生儿医学
背景情况:
- 妊娠期糖尿病酸性脂肪酸症 (DKA) 是妊娠期和孕期糖尿病的严重并发症.
- 有限的高质量的研究存在于DKA发作后的怀孕结果.
研究的目的:
- 系统地审查和评估因糖尿病酸性脂肪酸症而复杂的怀孕中母亲和新生儿的结果.
主要方法:
- 从1990年1月到2023年6月,对主要数据库 (PubMed,Embase,Web of Science,Google Scholar) 进行了全面的电子搜索.
- 包括随机临床试验和观察性研究;不包括评论,病例报告和非同行评审的出版物.
- 通过使用Cochrane RoB 2和JBI批判性评估工具来评估研究质量.
主要成果:
- 七项研究符合纳入标准;异质性排除了元分析.
- 观察到高水平的不良结果:死产 (7-35%),剖腹产 (49-64%),早产 (25-83%),以及新生儿重症监护室 (40-65%).
- 最近的研究表明,死产率为7-31%,大多数分析显示的比率低于17%.
结论:
- 糖尿病酸性脂肪酸症后的怀孕结果通常很差.
- 虽然死亡出生率可能会逐渐下降,但需要进一步进行精心设计的研究.
- 未来的研究应该集中在评估DKA的管理和怀孕的结果.
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