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妊娠期糖尿病及其危险因素的筛查:根据葡萄糖耐量试验结果分析有妊娠期糖尿病危险因素女性的妊娠结局

Screening of Gestational Diabetes and Its Risk Factors: Pregnancy Outcome of Women with Gestational Diabetes Risk Factors According to Glycose Tolerance Test Results.

作者信息

Hanson Ele, Ringmets Inge, Kirss Anne, Laan Maris, Rull Kristiina

机构信息

Department of Obstetrics and Gynaecology, Institute of Clinical Medicine, University of Tartu, Puusepa St. 8, 50406 Tartu, Estonia.

Women's Clinic, Tartu University Hospital, Puusepa St. 8, 50406 Tartu, Estonia.

出版信息

J Clin Med. 2022 Aug 23;11(17):4953. doi: 10.3390/jcm11174953.

Abstract

: Gestational diabetes mellitus (GDM) can cause maternal and neonatal health problems, and its prevalence is increasing worldwide. We assessed the screening of GDM during a 7-year period and compared the outcome of pregnancies at high risk for GDM. : We analyzed non-selected pregnant women ( = 5021) receiving antenatal care in Tartu University Hospital, Estonia in 2012-2018. Pregnant women were classified based on the absence or presence of GDM risk factors as low risk ( = 2302) or high risk for GDM ( = 2719), respectively. The latter were divided into subgroups after the oral glycose tolerance test (OGTT): GDM ( = 423), normal result ( = 1357) and not tested ( = 939). : The proportion of women with GDM risk factors increased from 43.5% in 2012 to 57.8% in 2018, and the diagnosis of GDM more than doubled (5.2% vs. 13.7%). Pregnancies predisposed to GDM but with normal OGTT results were accompanied by an excessive gestational weight gain and increased odds to deliver a LGA baby (AOR 2.3 (CI 1.8-3.0)). : An increasing number of pregnancies presenting GDM risk factors are diagnosed with GDM. Pregnant women with GDM risk factors are, despite normal OGTT, at risk of increased weight gain and LGA newborns.

摘要

妊娠期糖尿病(GDM)可导致母婴健康问题,且其在全球范围内的患病率正在上升。我们评估了7年间GDM的筛查情况,并比较了GDM高危妊娠的结局。

我们分析了2012年至2018年在爱沙尼亚塔尔图大学医院接受产前护理的非选择性孕妇(n = 5021)。根据是否存在GDM危险因素,孕妇分别被分类为低风险(n = 2302)或GDM高危(n = 2719)。后者在口服葡萄糖耐量试验(OGTT)后被分为亚组:GDM(n = 423)、结果正常(n = 1357)和未进行检测(n = 939)。

有GDM危险因素的女性比例从2012年的43.5%增至2018年的57.8%,GDM的诊断增加了一倍多(5.2%对13.7%)。OGTT结果正常但易患GDM的妊娠伴有孕期体重过度增加以及分娩巨大儿的几率增加(调整后比值比2.3(95%置信区间1.8 - 3.0))。

越来越多有GDM危险因素的妊娠被诊断为GDM。有GDM危险因素的孕妇尽管OGTT结果正常,但仍有体重增加和新生儿为巨大儿的风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0ea9/9456276/cec04e51103e/jcm-11-04953-g001.jpg

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