【摘要】 妊娠合并糖尿病包括孕前糖尿病(PGDM)和妊娠期糖尿病(GDM),与母儿近远期并发症有关。糖化血红蛋白(HbA1c)可反映近2～3个月血糖水平,近年来用作非妊娠期糖尿病的诊断标准之一。很多学者对不同妊娠时期HbA1c水平能否预测GDM的发生、母儿不良妊娠结局和母亲产后糖尿病发生风险以及不同种族HbA1c水平差异、HbA1c水平的影响因素等方面进行了大量研究,多数认为HbA1c作为GDM的诊断指标敏感度不高,可能增加漏诊率,但其单独或与更多指标联合是筛查和诊断GDM的有力补充,可以减少口服葡萄糖耐量试验(OGTT)的检测。孕期不同时点的HbA1c水平均可能与妊娠结局有关,而产前HbA1c水平对识别可能进展为2型糖尿病的高危GDM孕妇也有一定的价值。不过,对HbA1c的截断值、包含HbA1c的不同筛查诊断策略意见尚不统一,仍需更多的研究进一步明确。更多还原

【Abstract】 Pregnancies complicated with diabetes mellitus including pre-gestational diabetes mellitus(PGDM) and gestational diabetes mellitus(GDM), are at risk of developing a number of serious obstetric complications as well as having longterm implications for the wellbeing of mother and infant. Glycated hemoglobin(HbA1 c) may reflect glucose levels over the previous 2-3 months, and acts as one of the diagnostic criteria outside of pregnancy recently. Many studies had been carried through about the role of HbA1 c in pregnancy, included how can HbA1 c in different gestational weeks predict GDM subsequently and adverse pregnancy outcomes even postpartum diabetes risk, the difference of HbA1 c levels in different races and the influence factors of HbA1 c levels. Further, whether HbA1 c level is various in different ethnical and the influence factors of HbA1 c level had been investigated. Most authors believed that HbA1 c, as a diagnostic indicator of GDM, is not highly sensitive and may increase the rate of missed diagnosis. HbA1 c alone or in combination with more indicators is a powerful supplement in screening and diagnosis of GDM and can reduce the number of oral glucose tolerance test(OGTT). HbA1 c levels at different time points during pregnancy may be correlated with pregnancy outcomes, and prenatal HbA1 c levels are also of certain value in identifying high-risk GDM pregnant women who may progress to T2 DM. On account of the cut-off value of HbA1 c, the strategies of GDM screen and diagnosis with HbA1 c are inconsistent, more researches are needed further.更多还原