Swami Smita R, Mehetre Rushikesh, Shivane Vyankatesh, Bandgar Tushar R, Menon Padma S, Shah Nalini S
Department of Endocrinology, Seth GS Medical College and KEM Hospital, Mumbai.
J Indian Med Assoc. 2008 Nov;106(11):712-4, 735.
This was a study to assess the prevalence of carbohydrate intolerance of varying degrees in pregnant females registered at a tertiary care hospital in western India. Prospective screening of pregnant females was carried out (2005-2007) with oral glucose tolerance test (OGTT) based on American Diabetes Association (ADA) 2005 criteria. One thousand two hundred and twenty-five women with mean age 25.4 years (18-40) of which average risk and high risk were found in 408 (33.3%) and 817 (66.7%) cases respectively. Gestational diabetes mellitus (GDM) was diagnosed in 94 cases (7.7%) while 171(13.9%) had impaired gestational glucose tolerance (IGGT) ie, one value abnormal on 3-hour OGTT, while the combined prevalence of GDM and IGGT was 21.6% (n=265). Prevalence of GDM and IGGT was more in patients with age more than 30 years compared to younger females [GDM: 17.6% versus 6.8% (p=0.00); IGGT : 21% versus 13.4% (p=0.00)]; and in those with body mass index (BMI) >23 compared to BMI<23[GDM: 11.4% versus 8.3% (p=0.0374); IGGT : 22.8% versus 10.5 % (p= 0.0028)]. As the maternal age [odd's ratio {OR} :1.32; confidence interval {CI} (1.20 - 1.55) (p=0.000)] and prepregnancy BMI [OR:1.43; CI (0.65 - 3.14), (p=0.0316)] increases; prevalence of GDM, IGGT increased. There was a non-significant trend of increased GDM and IGGT in patients with family history of diabetes, bad obstetric history, history of macrosomic baby and decreased physical activity. So it is concluded GDM and IGGT affects one-fifth of pregnant females from western India on selective screening with increasing maternal age and BMI being significant risk factors associated.
这是一项旨在评估印度西部一家三级护理医院登记的孕妇中不同程度碳水化合物不耐受患病率的研究。基于美国糖尿病协会（ADA）2005年标准，对孕妇进行了前瞻性筛查（2005 - 2007年），采用口服葡萄糖耐量试验（OGTT）。1225名平均年龄为25.4岁（18 - 40岁）的女性中，分别有408例（33.3%）和817例（66.7%）为平均风险和高风险。94例（7.7%）被诊断为妊娠期糖尿病（GDM），171例（13.9%）有妊娠期糖耐量受损（IGGT），即3小时OGTT中有一项值异常，GDM和IGGT的合并患病率为21.6%（n = 265）。与年轻女性相比，年龄超过30岁的患者中GDM和IGGT的患病率更高[GDM：17.6%对6.8%（p = 0.00）；IGGT：21%对13.4%（p = 0.00）]；体重指数（BMI）>23的患者与BMI<23的患者相比[GDM：11.4%对8.3%（p = 0.0374）；IGGT：22.8%对10.5%（p = 0.0028）]。随着母亲年龄[优势比{OR}：1.32；置信区间{CI}（1.20 - 1.55）（p = 0.000）]和孕前BMI[OR：1.43；CI（0.65 - 3.14），（p = 0.0316）]增加，GDM、IGGT的患病率增加。有糖尿病家族史、不良产科史、巨大儿史且身体活动减少的患者中，GDM和IGGT有增加的非显著趋势。因此得出结论，在印度西部，通过选择性筛查发现GDM和IGGT影响五分之一的孕妇，母亲年龄增加和BMI是相关的重要风险因素。
