接受体外受精的孕妇中妊娠期糖尿病的患病率、发病机制特点及风险因素

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论证。不孕夫妇数量的增加促使辅助生殖技术被广泛用于实现生育愿望。研究表明，辅助生殖技术是妊娠严重并发症——妊娠期糖尿病的独立风险因素。由于妊娠期糖尿病具有多因素、多基因特性，且在接受体外受精后具有较高的发病率，因此这一问题的研究引起了特别关注。

目的。探讨接受体外受精的孕妇中妊娠期糖尿病的患病率、发病机制特点及可能的风险因素。

材料与方法。分析了来自eLibrary和PubMed数据库的相关研究，内容涵盖辅助生殖技术后妊娠期糖尿病的患病率、风险因素和发病机制特点。对2018–2022年间116例单胎妊娠孕妇的门诊和住院病历进行了回顾性与前瞻性分析。研究组包括 77 例（66%）经体外受精后被诊断为妊娠期糖尿病的孕妇，对照组为 39 例（34%）体外受精后未患妊娠期糖尿病的孕妇。

结果。接受体外受精的孕妇中妊娠期糖尿病的发病率显著高于普通孕妇人群，部分研究显示高达 12.6%。妊娠期糖尿病是一种多基因、多因素性疾病，其发病机制是在存在特定基因多态性关联的情况下，由表观遗传因素诱发启动。研究发现，较高的妊娠前体质指数是体外受精后妊娠期糖尿病的重要风险因素，而体外受精尝试次数及促卵泡生成素与促黄体生成素的比值对妊娠期糖尿病的发生无显著影响。不孕的病因在部分研究中被认为可能是妊娠期糖尿病的风险因素之一，但本研究中不同不孕病因组之间的差异无统计学意义（p > 0.05）。

结论。子宫动脉栓塞术后不孕治疗、妊娠及分娩的临床管理经验了解妊娠期糖尿病的发病机制特点，并识别和及时干预体外受精孕妇中可能的风险因素，有助于早期纠正糖代谢紊乱。由于妊娠期糖尿病孕妇在妊娠期并发症及未来发展为2型糖尿病方面具有较高风险，因此对该人群的管理尤为重要。

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作者简介

Kristina Sh. Balabanova

Moscow Regional Research Institute of Obstetrics and Gynecology named after academician V.I. Krasnopolsky

编辑信件的主要联系方式.
Email: Kalseidova-k@yandex.ru
ORCID iD: 0000-0002-8581-9159
SPIN 代码: 9386-5574
俄罗斯联邦, Moscow

Vasiliy A. Petrukhin

Moscow Regional Research and Clinical Institute

Email: Petruhin271058@mail.ru
ORCID iD: 0000-0003-0460-3047
SPIN 代码: 9236-6783

MD, Dr. Sci. (Medicine), Professor

俄罗斯联邦, Moscow

Fatima F. Burumkulova

Moscow Regional Research Institute of Obstetrics and Gynecology named after academician V.I. Krasnopolsky

Email: Fatima-burumkulova@yandex.ru
ORCID iD: 0000-0001-9327-0656
SPIN 代码: 6592-7736

MD, Dr. Sci. (Medicine), Professor

俄罗斯联邦, Moscow

Tatyana S. Kovalenko

Moscow Regional Research Institute of Obstetrics and Gynecology named after academician V.I. Krasnopolsky

Email: Zurik2668@yandex.ru
ORCID iD: 0000-0001-8995-6727
SPIN 代码: 9363-7088

MD, Cand. Sci. (Medicine)

俄罗斯联邦, Moscow

Kseniya V. Krasnopolskaya

Moscow Regional Research Institute of Obstetrics and Gynecology named after academician V.I. Krasnopolsky

Email: Kkv@mail.ru
ORCID iD: 0000-0002-1275-9220
SPIN 代码: 1252-3811

MD, Dr. Sci. (Medicine), Professor

俄罗斯联邦, Moscow

Anastasiya O. Garina

Moscow Regional Research Institute of Obstetrics and Gynecology named after academician V.I. Krasnopolsky; Bauman Moscow State Technical University

Email: Garinaa@inbox.ru
ORCID iD: 0000-0002-2313-746X
俄罗斯联邦, Moscow; Moscow

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