PDF(Pubmed)
Abstract：
UNASSIGNED: Gestational diabetes mellitus (GDM) is a common metabolic disorder linked to adverse pregnancy outcomes. Recent research indicates that HbA1c is reliable in detecting maternal glycemia during the first trimester but may underestimate glucose intolerance in the late second to third trimesters. Therefore, it is reasonable to hypothesize that mothers with GDM, despite apparently normal HbA1c levels in the third trimester, may give birth to infants displaying characteristic features often seen in infants of diabetic mothers with suboptimal glycemic control. This study aimed to describe a case series of autopsy cases involving stillborn or deceased neonates delivered in the third trimester to mothers diagnosed with GDM and having normal HbA1c levels at or around the time of delivery. The primary focus was on identifying and documenting the characteristic features commonly associated with \"infants of diabetic mothers\" with suboptimal glycemic control in this series of cases.
UNASSIGNED: We conducted a retrospective review of autopsy reports from our institution spanning 7.5 years. The study included cases that met the following criteria: (1) stillborn or infants who died in the early neonatal period, delivered in the third trimester; (2) mothers diagnosed with GDM; (3) normal maternal HbA1c levels of ≤6.1% at or around the time of delivery; (4) birthweight or femoral length exceeding the 90th percentile for gestational age; and (5) absence of genetic aberrations. We also examined these cases for other characteristic features associated with \"infants of diabetic mothers.\"
UNASSIGNED: Ten autopsy cases met our inclusion criteria, including 9 stillbirths and 1 neonatal death. Gestational age at delivery ranged from 32 to 39 weeks (mean: 35.7 weeks). Femoral length exceeded the 90th percentile in all cases, and 6 cases had birthweights above the 90th percentile. Puffy facies were observed in 6 cases. Among the 9 cases with complete autopsies including internal examination, 6 exhibited excess adipose tissue, 4 had cardiomegaly, and 3 showed pancreatic islet hyperplasia. Hypoxic-ischemic encephalopathy was detected in 7 cases. No structural abnormalities were noted.
UNASSIGNED: Our findings demonstrated that fetuses and neonates born to mothers with apparently normal HbA1c levels in the third trimester could still display characteristic features commonly observed in infants of diabetic mothers with poor glycemic control, also known as \"infants of diabetic mothers.\" This study underscores the potential of third-trimester maternal HbA1c measurements to underestimate maternal glycemia and its consequential impact on fetal development, as well as the subsequent manifestation of features of \"infants of diabetic mothers.\"
UNASSIGNED: We conducted a retrospective review of autopsy reports from our institution spanning 7.5 years. The study included cases that met the following criteria: (1) stillborn or infants who died in the early neonatal period, delivered in the third trimester; (2) mothers diagnosed with GDM; (3) normal maternal HbA1c levels of ≤6.1% at or around the time of delivery; (4) birthweight or femoral length exceeding the 90th percentile for gestational age; and (5) absence of genetic aberrations. We also examined these cases for other characteristic features associated with \"infants of diabetic mothers.\"
UNASSIGNED: Ten autopsy cases met our inclusion criteria, including 9 stillbirths and 1 neonatal death. Gestational age at delivery ranged from 32 to 39 weeks (mean: 35.7 weeks). Femoral length exceeded the 90th percentile in all cases, and 6 cases had birthweights above the 90th percentile. Puffy facies were observed in 6 cases. Among the 9 cases with complete autopsies including internal examination, 6 exhibited excess adipose tissue, 4 had cardiomegaly, and 3 showed pancreatic islet hyperplasia. Hypoxic-ischemic encephalopathy was detected in 7 cases. No structural abnormalities were noted.
UNASSIGNED: Our findings demonstrated that fetuses and neonates born to mothers with apparently normal HbA1c levels in the third trimester could still display characteristic features commonly observed in infants of diabetic mothers with poor glycemic control, also known as \"infants of diabetic mothers.\" This study underscores the potential of third-trimester maternal HbA1c measurements to underestimate maternal glycemia and its consequential impact on fetal development, as well as the subsequent manifestation of features of \"infants of diabetic mothers.\"
摘要：
妊娠糖尿病（GDM）是一种常见的代谢紊乱，与不良妊娠结局有关。最近的研究表明，HbA1c在检测妊娠早期的母体血糖方面是可靠的，但可能低估了妊娠晚期至妊娠晚期的葡萄糖耐受不良。因此,可以合理地假设患有GDM的母亲，尽管妊娠晚期HbA1c水平明显正常，可能会产生具有特征性特征的婴儿，这些特征常见于血糖控制不佳的糖尿病母亲的婴儿。这项研究旨在描述一系列尸检病例，涉及在妊娠晚期将死产或死亡的新生儿交付给被诊断为GDM且在分娩时或分娩前后HbA1c水平正常的母亲。主要重点是识别和记录这一系列病例中通常与血糖控制欠佳的“糖尿病母亲婴儿”相关的特征。
■我们对我们机构的尸检报告进行了为期7.5年的回顾性审查。该研究包括符合以下标准的病例：（1）死产或在新生儿早期死亡的婴儿，在妊娠晚期分娩;(2)被诊断为GDM的母亲;(3)在分娩时或分娩前后的正常母体HbA1c水平≤6.1%;(4)出生体重或股骨长度超过胎龄第90百分位数;(5)没有遗传畸变。我们还检查了这些病例与糖尿病母亲的婴儿相关的其他特征。\"
■十个尸检病例符合我们的纳入标准,包括9例死产和1例新生儿死亡。分娩时的妊娠年龄为32至39周（平均：35.7周）。在所有情况下，股骨长度超过第90百分位数，6例出生体重高于第90百分位数。6例出现浮肿相。在包括内部检查在内的完整尸检的9例中，6表现出过量的脂肪组织，4有心脏肥大，3显示胰岛增生。7例检出缺氧缺血性脑病。没有发现结构异常。
我们的研究结果表明，妊娠晚期HbA1c水平明显正常的母亲所生的胎儿和新生儿仍然可以表现出通常在血糖控制不佳的糖尿病母亲婴儿中观察到的特征。也被称为“糖尿病母亲的婴儿”。“这项研究强调了孕晚期孕妇HbA1c测量可能低估孕妇血糖及其对胎儿发育的影响，以及糖尿病母亲婴儿特征的后续表现。\"
■我们对我们机构的尸检报告进行了为期7.5年的回顾性审查。该研究包括符合以下标准的病例：（1）死产或在新生儿早期死亡的婴儿，在妊娠晚期分娩;(2)被诊断为GDM的母亲;(3)在分娩时或分娩前后的正常母体HbA1c水平≤6.1%;(4)出生体重或股骨长度超过胎龄第90百分位数;(5)没有遗传畸变。我们还检查了这些病例与糖尿病母亲的婴儿相关的其他特征。\"
■十个尸检病例符合我们的纳入标准,包括9例死产和1例新生儿死亡。分娩时的妊娠年龄为32至39周（平均：35.7周）。在所有情况下，股骨长度超过第90百分位数，6例出生体重高于第90百分位数。6例出现浮肿相。在包括内部检查在内的完整尸检的9例中，6表现出过量的脂肪组织，4有心脏肥大，3显示胰岛增生。7例检出缺氧缺血性脑病。没有发现结构异常。
我们的研究结果表明，妊娠晚期HbA1c水平明显正常的母亲所生的胎儿和新生儿仍然可以表现出通常在血糖控制不佳的糖尿病母亲婴儿中观察到的特征。也被称为“糖尿病母亲的婴儿”。“这项研究强调了孕晚期孕妇HbA1c测量可能低估孕妇血糖及其对胎儿发育的影响，以及糖尿病母亲婴儿特征的后续表现。\"
