Textbook of Diabetes and Pregnancy
http://www.100md.com
《新英格兰医药杂志》
The field of diabetes in pregnancy was last reviewed by J?rgen Pedersen in his classic 1977 monograph, The Pregnant Diabetic and Her Newborn (Copenhagen: Munksgaard; Baltimore: Williams & Wilkins). Therefore, this book edited by Moshe Hod and his group of internationally recognized experts is timely. Many of Hod's contributors are leading investigators in all aspects of diabetes in pregnancy. As a result of the great progress made in this field and the editors' attempt to be inclusive (topics range from maternal metabolism to the legal aspects of care), this work does not provide the in-depth detail that could be important to a worker focused on a particular aspect of the field. It is, however, an excellent general resource and is well suited for the trainee, particularly in obstetrics, who will care for the pregnant woman with diabetes and her offspring.
Improving our understanding of how the physiological perturbations of diabetes adversely affect the mother and her child before and after birth, in both the immediate and long term, has been central to advances in care that have dramatically reduced perinatal mortality rates to those typical of nondiabetic pregnancies. The numerous aspects of these changes are presented in well-written chapters on topics ranging from the immunology of gestational diabetes to the biology of amniotic fluid. These insights have been adapted by clinicians to develop strategies for making the altered metabolism of the diabetic woman normal during pregnancy and thus to improve the outcome. These strategies are nicely presented in chapters concerning the pharmacologic, nutritional, and obstetrical management of the diabetic pregnancy.
The most fascinating aspect of the problem of diabetes in pregnancy is the delineation of the many alterations of maternal physiology and the ways in which they affect the conceptus. These changes cause not only congenital malformations and neonatal problems but also long-term complications such as altered neurophysiologic development, a propensity toward obesity, altered glucose metabolism, and other problems. Several chapters cover the considerable efforts of the past quarter-century to identify the mechanisms behind the increased risk of malformations in the embryos of diabetic women. Less is known and little is presented about how maternal diabetes causes problems for the offspring later in life. Identifying the mechanisms responsible for the fetal origins of adult disease is an exciting new area of perinatal research, and diabetes in pregnancy offers an excellent model with which to investigate this fascinating question.
All who work in the area of diabetes in pregnancy will enjoy the first four chapters of this book, which nicely describe the evolution of knowledge and provide insights about the founders of this field — J?rgen Pedersen, Priscilla White (Figure), Elliott Joslin, Norbert Freinkel, and others. Each made seminal observations in basic and clinical research on which present treatment strategies are based. Their stories are outstanding examples of how a lifetime commitment to the understanding of a multifaceted problem can dramatically improve the outcome of pregnancy.
Priscilla White.
Courtesy of the National Library of Medicine.
Edward S. Ogata, M.D.
Children's Memorial Hospital
Chicago, IL 60614
eogata@childrensmemorial.org(Edited by Moshe Hod, Lois)
Improving our understanding of how the physiological perturbations of diabetes adversely affect the mother and her child before and after birth, in both the immediate and long term, has been central to advances in care that have dramatically reduced perinatal mortality rates to those typical of nondiabetic pregnancies. The numerous aspects of these changes are presented in well-written chapters on topics ranging from the immunology of gestational diabetes to the biology of amniotic fluid. These insights have been adapted by clinicians to develop strategies for making the altered metabolism of the diabetic woman normal during pregnancy and thus to improve the outcome. These strategies are nicely presented in chapters concerning the pharmacologic, nutritional, and obstetrical management of the diabetic pregnancy.
The most fascinating aspect of the problem of diabetes in pregnancy is the delineation of the many alterations of maternal physiology and the ways in which they affect the conceptus. These changes cause not only congenital malformations and neonatal problems but also long-term complications such as altered neurophysiologic development, a propensity toward obesity, altered glucose metabolism, and other problems. Several chapters cover the considerable efforts of the past quarter-century to identify the mechanisms behind the increased risk of malformations in the embryos of diabetic women. Less is known and little is presented about how maternal diabetes causes problems for the offspring later in life. Identifying the mechanisms responsible for the fetal origins of adult disease is an exciting new area of perinatal research, and diabetes in pregnancy offers an excellent model with which to investigate this fascinating question.
All who work in the area of diabetes in pregnancy will enjoy the first four chapters of this book, which nicely describe the evolution of knowledge and provide insights about the founders of this field — J?rgen Pedersen, Priscilla White (Figure), Elliott Joslin, Norbert Freinkel, and others. Each made seminal observations in basic and clinical research on which present treatment strategies are based. Their stories are outstanding examples of how a lifetime commitment to the understanding of a multifaceted problem can dramatically improve the outcome of pregnancy.
Priscilla White.
Courtesy of the National Library of Medicine.
Edward S. Ogata, M.D.
Children's Memorial Hospital
Chicago, IL 60614
eogata@childrensmemorial.org(Edited by Moshe Hod, Lois)