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頁籤選單縮合
題名 | Clinical analysis of infants of diabetic mothers=糖尿病母親所生嬰兒之臨床分析 |
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作者 | 林正焜; | 書刊名 | 中華民國小兒科醫學會雜誌 |
卷期 | 30:4 民78.07-08 |
頁次 | 頁233-239 |
分類號 | 417.5012 |
關鍵詞 | 糖尿病母親; 嬰兒; |
語文 | 英文(English) |
中文摘要 | 爲了瞭解母親罹患糖尿病的嬰兒的週産期死亡率、罹病率及先天畸型的情形,我們分析15年來(1974-1988)在台大醫院出生的病例,排除其中孕期未滿20週及由於胎兒不正常而轉來本院生産的患者,共有82例可供分析。其週期死亡率爲6.1%;先天畸型率爲15.9%,其中以先天性心臓病最多,泌尿系統畸型次之。同一時期台大醫院的先天畸型率佔所有新生兒的1.65%。由於胎兒器官之成形在懷孕初期6至8週完成,我們乃予比較此時期母親血糖值與嬰兒畸型的關係。共25例有些時期母親空腹血糖值,其中5例嬰兒有先天畸型,這些嬰兒的母親血糖值顯然比嬰兒無畸形的母親血糖值爲高(P<0.5)。 其他罹病情形,在78名活産兒中過重兒有35.9%,過輕兒有12.8%,早産兒12.8%,呼吸窘迫17.9%,5分鈡Apgar分烽小於7有6.4%,産程神以損傷2.6%,低血糖10.3%,膽紅素過高28.2%,紅血球過多12.8%,低血鈣5.1%,心肌肥厚症3.8%,只有22名活産兒既無先天畸型,也無上述罹病情形。文獻顯示嚴格的血糖控制可以減少母親罹患糖尿病的嬰兒的罹病率及減輕罹病的嚴重程度。同時若要減少先天畸型率,惟有懷孕初期的嚴格控制才有效果。從我們的結果看來,醫療人員亟取加強尿病患者懷孕前及孕期的血糖控制及教育。 |
英文摘要 | The clinical spectra of 82 infants of diabetic mothers (IDMs) encountered in past 15 years are presented. The perinatal mortality rate was 6.1% The observed morbidities of the 78 live-born IDMs were : large for gestational age, 35.9%; prematurity, 12.8%; small for gestational age, 12.8% respitatory distress, 17.9% low Apgar score, 6.4%; nerve injury, 2.6%; hypoglycemia, 10.3%; hyperbilirubinemia, 28.2%; polycythemia, 12.8%; hypocalcemia, 5.1%; hypertophic cardiomyopathy, 3.8%. Furthermore, 15.9 (13/82) of these infants suffered from congenital malformation, a rate nearly 10 times higher than that of the general neonatal population born in this hospital. In comparing sugar control during organogenesis, the mothers who had malformed infants had significantly higher fasting plasma glucose level than the mothers who had normal infants (P<0.05). Since tight control of maternal diabetes is mandatory to reduce the prevalence of mortality and malformation of the IDMs, we suggest that there is an urgent need to improve health education and supervision before and during pregnancy in all diabetic women. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。