"我这么瘦，怎么会患妊娠期糖尿病？""我只是血糖高一点，生完孩子就好了，应该没什么关系 吧？"……在妇产科，准妈妈们类似的问题几乎每天都能听到。随着生活方式的改变和诊断标准的更 新，妊娠期糖尿病已成为我国孕期最常见的并发症之一。本文旨在澄清公众对妊娠期糖尿病的常见误 区，提供科学、实用的知识，帮助准妈妈们正确认识、积极应对这一"甜蜜的负担"。 我国妊娠期糖尿病发病率仍在上升 最新的流行病学数据显示，我国妊娠期糖尿病发病率高达17.5%，相当于每6位孕妇中就有1位面临这一 问题。随着二孩、三孩政策的开放和高龄孕妇比例的增加，这一数字仍在上升。 然而，公众对妊娠期糖尿病的认知却存在显著不足与误区。许多准妈妈要么过度焦虑，要么不当回事， 这两种态度都可能对母婴健康造成不利影响。 妊娠期糖尿病，是指妊娠期间首次发生或发现的不同程度的糖代谢异常。这主要由于妊娠期胎盘分泌的 激素（如孕激素、雌激素）会对抗胰岛素的作用，导致胰岛素抵抗增加。当孕妇的胰岛功能无法代偿这 种抵抗时，血糖就会升高。 绝大多数妊娠期糖尿病发生在孕24～28周，且多数在产后能恢复正常。但它显著增加未来患2型糖尿病 的风险。因此，糖尿病筛查对孕妇来说非 ...

妊娠期糖尿病对母婴双方均可产生严重不良影响。对孕妈来说,会增加流产、妊娠高血压以及分娩时产 道损伤、难产的发生风险；对于宝宝来说,宝宝发生巨大儿、胎儿生长受限、胎儿畸形、早产的概率都 会增加。对新生儿的影响,患呼吸窘迫综合征、低血糖、新生儿黄疸等疾病的风险也会更高。 GDM主要与妊娠期体内激素变化,尤其是雌激素、孕激素等激素水平显著增高有关。同时,随着胎儿的生 长发育,母体对葡萄糖的需求量也在逐步增加,而胰岛素分泌可能相对不足,这也是导致妊娠期糖尿病的重 要原因之一。此外,年龄≥35岁、超重、多囊卵巢综合征、巨大儿分娩史、糖尿病家族史等个体高危因素 也与之相关。 近年来,随着生活水平的提高和高龄孕妇的增加,妊娠糖尿病的发病率明显增高,一旦病情控制不好,对孕妇 及胎儿均可造成不利影响,导致母婴不良妊娠结局增加。 孕期糖尿病分两种情况:一种情况是指怀孕前已经明确诊断患有糖尿病(1型或2型),另一种情况是孕前没 有糖尿病,怀孕以后发生了糖代谢异常,称为妊娠期糖尿病(GDM)。 妊娠期糖尿病一般发生在妊娠中晚期,症状隐匿不典型,单凭症状可能难以及时发现,因此,需要在孕24～28 周进行糖耐量试验(OGTT)的筛查,以 ...

Core Insights - The article discusses the impact of intrauterine hyperglycemia (IUHG) on the development of primordial germ cells (PGC) and fertility, particularly emphasizing its detrimental effects on female offspring [2][5][8] - A recent study published in Cell Discovery reveals that IUHG disrupts sex-specific epigenetic reprogramming during PGC development, leading to reproductive health issues and intergenerational effects [2][8] Group 1: Research Findings - IUHG significantly disrupts the development of PGCs, with a more pronounced effect on female offspring, resulting in reduced fertility [5][8] - The study utilized transgenic mice exposed to high glucose environments to systematically investigate the effects of IUHG on PGC development, revealing that IUHG affects chromatin accessibility and DNA methylation reprogramming in a sex-specific manner [5][6] Group 2: Mechanisms of Impact - In female embryos, IUHG leads to abnormal retention of chromatin accessibility at pluripotency gene promoters, inhibiting normal gene silencing and blocking the initiation of meiosis, ultimately hindering oocyte maturation [6][8] - In contrast, male embryos experience less severe effects on chromatin accessibility and gene transcription, but global DNA methylation reprogramming is impaired, particularly in key imprinted gene regions, indicating potential developmental impacts on future generations [6][8] Group 3: Implications and Future Directions - The findings underscore the importance of blood sugar management during pregnancy and suggest new avenues for improving reproductive health in offspring through metabolic intervention or epigenetic regulation [8]

Core Viewpoint - The article discusses the safety concerns and recommendations regarding the use of GLP-1 medications during pregnancy and breastfeeding, highlighting the need for caution and further research in this area [1][3]. Group 1: Research on GLP-1 Medications and Pregnancy - A large study published in January 2024 in JAMA Internal Medicine tracked around 50,000 children born to mothers with type 2 diabetes who used GLP-1 or insulin in early pregnancy, finding no increased risk of congenital defects compared to insulin use [5]. - Another study published in 2023 reviewed 39 independent studies on the effects of GLP-1 agonists and SGLT2 inhibitors during pregnancy and breastfeeding, concluding that there is extremely limited information on their safety [6]. Group 2: Risks Associated with GLP-1 Use During Pregnancy - Potential risks of GLP-1 medications during pregnancy may include miscarriage, low birth weight, and congenital defects, primarily due to their impact on maternal food intake and weight gain [6][7]. - Although concerns are mainly based on animal studies, the lack of human research has led to recommendations for discontinuation during pregnancy [7]. Group 3: Recommendations for Women Planning to Become Pregnant - Women are advised to stop using any GLP-1 medications at least two months before attempting to conceive, along with adopting additional preconception lifestyle measures [8]. - The American Diabetes Association recommends insulin as the preferred medication for managing diabetes during pregnancy, while other diabetes medications like metformin and glipizide are not first-line treatments due to their placental transfer [7][8]. Group 4: Breastfeeding Considerations - There is insufficient research to determine the safety of GLP-1 medications during breastfeeding, leading to recommendations against their use during this period [9][10].