二甲双胍与胰岛素对母亲妊娠期糖尿病新生儿安全性的系统评价

中国临床药理学与治疗学 ›› 2014, Vol. 19 ›› Issue (10): 1139-1143.

二甲双胍与胰岛素对母亲妊娠期糖尿病新生儿安全性的系统评价

阮冠宇, 许秋星, 蔡慧雅, 邓婕, 史道华

福建省妇幼保健院药剂科,福州 350001,福建

收稿日期:2013-08-01 修回日期:2014-09-24 出版日期:2014-10-26 发布日期:2014-10-29
通讯作者: 史道华,男,教授,主任药师,硕士生导师,研究方向:药理学和临床药学。Tel: 0591-88312079 E-mail: shidh@yeah.net
作者简介:阮冠宇,硕士,药师,研究方向:临床药学。 Tel: 0591-87506362 E-mail: rungy2004@163.com

Comparison of neonatal outcomes in women with gestational diabetes mellitus treated with metformin or insulin: a systematic review

RUAN Guan-yu, XU Qiu-xing, CAI Hui-ya, DENG Jie, SHI Dao-hua

Department of Pharmacy, Fujian Provincial Maternal and Children's Hospital, Fuzhou 350001, Fujian, China

Received:2013-08-01 Revised:2014-09-24 Online:2014-10-26 Published:2014-10-29

摘要/Abstract

摘要： 目的系统评价二甲双胍与胰岛素对母亲妊娠期糖尿病新生儿的安全性。方法检索Cochrane 图书馆、Pubmed、Web of knowledge、维普数据库、中文期刊全文数据库、万方数据库等文献数据库,纳入二甲双胍与胰岛素对比治疗妊娠期糖尿病新生儿安全性的随机对照研究。提取的资料经评价后采用RevMan 5.2软件进行Meta分析。结果共纳入7个随机对照试验,共 1 564 个患者。母亲接受二甲双胍治疗新生儿低血糖发生风险为胰岛素治疗的64% [95%CI: (0.46, 0.88)],而出生体质量、胎龄、脐动脉血pH、高胆红素血症发生率、呼吸窘迫综合征发生率等指标两组间均无显著差异。结论二甲双胍能降低新生儿低血糖发生风险,二甲双胍在治疗妊娠期糖尿病对新生儿是安全的。

关键词: 二甲双胍, 新生儿, 妊娠期糖尿病, 低血糖, 系统评价

Abstract: AIM: To evaluate the safety of neonatal outcomes in women with gestational diabetes mellitus(GDM) treated with metformin or insulin. METHODS: Randomized controlled trials (RCTs) about the clinical risks of metformin vs insulin on neonatal outcomes in women with GDM were retrieved on the Cochrane library, Pubmed, Web of knowledge, VIP, CNKI and Wangfang. The trials were screened according to the inclusion and exclusion criteria by two reviewers independently, the data were extracted, the methodological quality was assessed, and finally meta-analysis was performed by Rev Man5.2 software. RESULTS: A total of seven RCTs included 1 564 GDM patients. The incidence risk of neonatal hypoglycemia of metformin decreased 64% [95%CI: (0.46, 0.88)] compared with that in insulin. There were no significant differences in birthweight, gestational age, pH of umbilical artery, the incidence rate of hyperbilirubinemia or respiratory distress syndrome (RDS) between metformin and insulin. CONCLUSION: Metformin could associated with a decreased incidence risk of neonatal hypoglycemia and might be safe in newborn of women with GDM.

Key words: insulin, neonatal, metformin, gestational diabetes mellitus, systematic review

中图分类号:

R969.3

阮冠宇, 许秋星, 蔡慧雅, 邓婕, 史道华. 二甲双胍与胰岛素对母亲妊娠期糖尿病新生儿安全性的系统评价[J]. 中国临床药理学与治疗学, 2014, 19(10): 1139-1143.

RUAN Guan-yu, XU Qiu-xing, CAI Hui-ya, DENG Jie, SHI Dao-hua. Comparison of neonatal outcomes in women with gestational diabetes mellitus treated with metformin or insulin: a systematic review[J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2014, 19(10): 1139-1143.

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