50克葡萄糖耐量试验与亚洲多民族妊娠期糖尿病高危人群的妊娠结局
The 50-g glucose challenge test and pregnancy outcome in a multiethnic Asian population at high risk for gestational diabetes.
作者信息
Tan Peng Chiong, Ling Liza Ping, Omar Siti Zawiah
机构信息
Department of Obstetrics and Gynecology, Faculty of Medicine, University of Malaya, Lembah Pantai, Kuala Lumpur, Malaysia.
出版信息
Int J Gynaecol Obstet. 2009 Apr;105(1):50-5. doi: 10.1016/j.ijgo.2008.11.038. Epub 2009 Jan 19.
OBJECTIVE
To evaluate the 50-g glucose challenge test (GCT) on pregnancy outcome in a multiethnic Asian population at high risk for gestational diabetes (GDM).
METHODS
GCT was positive if the 1-hour plasma glucose level was >or=7.2 mmol/L. GDM was diagnosed by a 75-g glucose tolerance test using WHO (1999) criteria. Of the 1368 women enrolled in the study, 892 were GCT negative, 308 were GCT false-positive, and 168 had GDM. Pregnancy outcomes were extracted from hospital records. Multivariable logistic regression analysis was performed with GCT negative women as the reference group.
RESULTS
GCT false-positive status was associated with preterm birth (adjusted odds ratio [AOR] 2.1; 95% CI, 1.2-3.7) and postpartum hemorrhage (AOR 1.7; 95% CI, 1.0-2.7). GDM was associated with labor induction (AOR 5.0; 95% CI, 3.3-7.5), cesarean delivery (AOR 2.2; 95% CI, 1.6-3.2), postpartum hemorrhage (AOR 2.1; 95% CI, 1.2-3.7), and neonatal macrosomia (AOR 2.5; 95% CI, 1.0-6.0).
CONCLUSION
GCT false-positive women had an increased likelihood of an adverse pregnancy outcome. The role and threshold of the GCT needs re-evaluation.
目的
评估50克葡萄糖耐量试验（GCT）对亚洲多民族妊娠期糖尿病（GDM）高危人群妊娠结局的影响。
方法
若1小时血浆葡萄糖水平≥7.2 mmol/L，则GCT为阳性。采用世界卫生组织（1999年）标准，通过75克葡萄糖耐量试验诊断GDM。在纳入该研究的1368名女性中，892名GCT阴性，308名GCT假阳性，168名患有GDM。从医院记录中提取妊娠结局。以GCT阴性女性作为参照组进行多变量逻辑回归分析。
结果
GCT假阳性状态与早产（校正比值比[AOR] 2.1；95%置信区间[CI]，1.2 - 3.7）和产后出血（AOR 1.7；95% CI，1.0 - 2.7）相关。GDM与引产（AOR 5.0；95% CI，3.3 - 7.5）、剖宫产（AOR 2.2；95% CI，1.6 - 3.2）、产后出血（AOR 2.1；95% CI，1.2 - 3.7）及新生儿巨大儿（AOR 2.5；95% CI，1.0 - 6.0）相关。
结论
GCT假阳性女性出现不良妊娠结局的可能性增加。GCT的作用和阈值需要重新评估。
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