血浆葡萄糖水平高提高婴儿的心脏缺陷风险
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By LabMedica International staff writers Posted on 26 Jan 2018 |
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图片：在怀孕早期检验血液中的葡萄糖水平，评估先天性心脏病的风险（图片蒙Paras医院惠赐）。
多年来，医生们一直知道患糖尿病的妇女生小孩时婴儿心脏缺陷的风险更高，一些研究也显示，非糖尿病产妇的血糖水平与婴儿的心脏缺陷风险有关。
进行这类研究的一个难题是，非糖尿病孕妇的血糖水平不属常规测量项目。相反，孕妇一般在怀孕中期接受口腔葡萄糖耐受试验，以确定是否有妊娠期糖尿病，但进行这项试验时胎儿心脏早已成形。
美国加利福尼亚州斯坦福大学医学中心的一组科学家研究了19,107对母婴的病历，分娩日期是在2009到2015年之间。病历详细记载了产妇的产前护理，包括验血结果和孕期与产后给婴儿做的心脏诊断。科学家们分析了从估计的受孕日的四周前到妊娠第14周结束期间收集的任意血样的血液葡萄糖水平。拿到了2,292名受试者(13%)的早期葡萄糖测量值。他们还查看了妊娠20周左右时的口腔葡萄糖耐受试验(OGTT)结果，有不到一半的受试者——9,511人有这些数据。
排除怀孕前就有糖尿病或怀孕期间得糖尿病的妇女，结果显示，怀孕早期血液葡萄糖水平每升高10毫克/分升，生的小孩有先天性心脏缺陷的风险就升高8%。无先天性心脏缺陷(CHD)的怀孕早期血糖均值为96毫克/分升（5.3毫摩尔/升），而有CHD的怀孕早期血糖均值为107毫克/分升（6.0毫摩尔/升）。1小时OGTT均值分别为117毫克/分升（6.5 毫摩尔/升）和122毫克/分升（6.8毫摩尔/升）。
上述结果表明，怀孕早期测得的随机血浆葡萄糖值较高与无糖尿病产妇所生婴儿的先天性心脏病风险升高有关。再者，怀孕早期测得的血浆葡萄糖值与后代先天性心脏病风险的关联比OGTT更密切，OGTT常用于胎儿超声心动图筛查前的怀孕风险分级。
该研究的论文发表于2017年12月15日的《儿科杂志》(The Journal of Pediatrics)。资深作者、儿心内科助理教授James R. Priest大夫说：“小孩有先天性心脏病的妇女大多数没有糖尿病。我们发现，即使产妇没有糖尿病或在怀孕期间得糖尿病，我们仍能通过怀孕第一个三月期的葡萄糖值测到生的小孩有先天性心脏病的风险。”
Related Links:
斯坦福大学医学中心
进行这类研究的一个难题是，非糖尿病孕妇的血糖水平不属常规测量项目。相反，孕妇一般在怀孕中期接受口腔葡萄糖耐受试验，以确定是否有妊娠期糖尿病，但进行这项试验时胎儿心脏早已成形。
美国加利福尼亚州斯坦福大学医学中心的一组科学家研究了19,107对母婴的病历，分娩日期是在2009到2015年之间。病历详细记载了产妇的产前护理，包括验血结果和孕期与产后给婴儿做的心脏诊断。科学家们分析了从估计的受孕日的四周前到妊娠第14周结束期间收集的任意血样的血液葡萄糖水平。拿到了2,292名受试者(13%)的早期葡萄糖测量值。他们还查看了妊娠20周左右时的口腔葡萄糖耐受试验(OGTT)结果，有不到一半的受试者——9,511人有这些数据。
排除怀孕前就有糖尿病或怀孕期间得糖尿病的妇女，结果显示，怀孕早期血液葡萄糖水平每升高10毫克/分升，生的小孩有先天性心脏缺陷的风险就升高8%。无先天性心脏缺陷(CHD)的怀孕早期血糖均值为96毫克/分升（5.3毫摩尔/升），而有CHD的怀孕早期血糖均值为107毫克/分升（6.0毫摩尔/升）。1小时OGTT均值分别为117毫克/分升（6.5 毫摩尔/升）和122毫克/分升（6.8毫摩尔/升）。
上述结果表明，怀孕早期测得的随机血浆葡萄糖值较高与无糖尿病产妇所生婴儿的先天性心脏病风险升高有关。再者，怀孕早期测得的血浆葡萄糖值与后代先天性心脏病风险的关联比OGTT更密切，OGTT常用于胎儿超声心动图筛查前的怀孕风险分级。
该研究的论文发表于2017年12月15日的《儿科杂志》(The Journal of Pediatrics)。资深作者、儿心内科助理教授James R. Priest大夫说：“小孩有先天性心脏病的妇女大多数没有糖尿病。我们发现，即使产妇没有糖尿病或在怀孕期间得糖尿病，我们仍能通过怀孕第一个三月期的葡萄糖值测到生的小孩有先天性心脏病的风险。”
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斯坦福大学医学中心
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