Hossein-Nezhad Arash, Maghbooli Zhila, Vassigh Ali-Reza, Larijani Bagher
Endocrinology and Metabolism Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Taiwan J Obstet Gynecol. 2007 Sep;46(3):236-41. doi: 10.1016/S1028-4559(08)60026-1.
We investigated the prevalence and outcome of gestational diabetes mellitus (GDM) in pregnant Iranian women.
A total of 2,416 women, who were consecutive referrals for antenatal care to five university teaching hospitals in Tehran, were recruited. Patients with known diabetes were excluded. All 2,416 women were screened with a 50-g 1-hour glucose challenge test, and any woman with a plasma glucose concentration more than or equal to 130 mg/dL was given a 100-g 3-hour glucose tolerance test. Diagnosis of GDM was according to Carpenter and Coustan's criteria. The remainder served as controls for the study.
There were 114 women (4.7%; 95% confidence interval [CI], 3.9-5.6%) who had GDM. Women with GDM had a significantly higher parity and body mass index than non-diabetic women. Women with GDM were also more likely to have a family history of diabetes and a history of poor obstetric outcome. Of the 114 women, 27 (23.6%) were younger than 25 years old, and 16 (14.0%) had no recognizable risk factor for diabetes. The odds ratio (OR) for cesarean section (OR, 2.28; p = 0.0002), macrosomia (OR, 1.93; p = 0.0374), neonatal hypoglycemia (OR, 3.2; p = 0.011) and hypocalcemia (OR, 3.045; p = 0.0195), and still birth (OR, 4.8; p = 0.003) were all significantly higher in women with GDM than non-GDM controls.
One out of every 20 pregnant Iranian women will develop GDM, with significantly increased odds of adverse maternal and fetal outcome. The significant proportion of young and/or risk factor-free women in our sample means that there seems to be a case for universal GDM screening in pregnant Iranian women.
我们调查了伊朗孕妇中妊娠期糖尿病（GDM）的患病率及结局。
共招募了2416名连续到德黑兰五所大学教学医院接受产前检查的妇女。已知患有糖尿病的患者被排除。所有2416名妇女均接受了50克1小时葡萄糖耐量试验筛查，任何血糖浓度大于或等于130毫克/分升的妇女都进行了100克3小时葡萄糖耐量试验。GDM的诊断依据Carpenter和Coustan的标准。其余妇女作为本研究的对照。
有114名妇女（4.7%；95%置信区间[CI]，3.9 - 5.6%）患有GDM。患有GDM的妇女的产次和体重指数显著高于非糖尿病妇女。患有GDM的妇女也更有可能有糖尿病家族史和不良产科结局史。在这114名妇女中，27名（23.6%）年龄小于25岁，16名（14.0%）没有可识别的糖尿病危险因素。患有GDM的妇女剖宫产的比值比（OR，2.28；p = 0.0002）、巨大儿（OR，1.93；p = 0.0374）、新生儿低血糖（OR，3.2；p = 0.011）和低钙血症（OR，3.045；p = 0.0195）以及死产（OR，4.8；p = 0.003）均显著高于非GDM对照。
每20名伊朗孕妇中就有1名会患GDM，母婴不良结局的几率显著增加。我们样本中年轻和/或无危险因素的妇女比例较高，这意味着似乎有必要对伊朗孕妇进行普遍的GDM筛查。
