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1653例青少年妊娠中的妊娠期糖尿病和妊娠期糖耐量受损:患病率、危险因素及妊娠结局

Gestational diabetes and gestational impaired glucose tolerance in 1653 teenage pregnancies: prevalence, risk factors and pregnancy outcomes.

作者信息

Karcaaltincaba Deniz, Buyukkaragoz Bahar, Kandemir Omer, Yalvac Serdar, Kıykac-Altınbaş Sadiman, Haberal Ali

机构信息

Department of Obstetrics and Gynecology, Etlik Zubeyde Hanim Women's Hospital, Gazi University, Ankara, Turkey.

出版信息

J Pediatr Adolesc Gynecol. 2011 Apr;24(2):62-5. doi: 10.1016/j.jpag.2010.07.003. Epub 2010 Aug 14.

Abstract

STUDY OBJECTIVE

The aim of this study was to determine the prevalence of gestational diabetes mellitus (GDM) and gestational impaired glucose tolerance (GIGT) in adolescent pregnancies, associated risk factors, and pregnancy complications.

DESIGN

Retrospective study.

SETTINGS

Community-based teaching hospital.

PARTICIPANTS

Results of 1653 pregnant women age ≤ 19 years in 2005-2007 were reviewed.

INTERVENTION

All pregnant women screened with 50-g glucose challenge test (GCT) and patients with a GCT result ≥ 140 mg/dl underwent a 3-hour 100-g oral glucose tolerance test (OGTT).

MAIN OUTCOME MEASURES

GDM was diagnosed with at least two abnormal results and GIGT was diagnosed with one abnormal result. GDM and GIGT cases were evaluated for the presence of any associated risk factors and effects of presence of risk factors on pregnancy outcomes.

RESULTS

The prevalence of GDM was 0.85% (95% CI, 0.41-1.29), GIGT was 0.5% (95% CI, 0.15-0.81) and GDM+GIGT was 1.35% (95% CI, 0.78-1.88) by Carpenter and Coustan criteria. 68% of patients had at least one of the risk factors including body mass index ≥ 25, family history of diabetes and polycystic ovary syndrome (PCOS). Only 9.1% (n = 2) of them required insulin for glucose regulation during pregnancy with 9.1% (n = 2) macrosomia rate. All patients were primiparous and cesarean delivery rate was 27.3% (n = 6). We could not find any effect of presence of risk factors on pregnancy outcomes in GDM and GIGT cases.

CONCLUSION

We demonstrated that GDM and GIGT are strongly associated with high BMI before pregnancy, PCOS, and family history of diabetes. Since GDM is a state of prediabetes, it is important to diagnose in adolescent pregnancies considering their life expectancy to take preventive measures to avoid diabetes mellitus.

摘要

研究目的

本研究旨在确定青少年妊娠中妊娠期糖尿病(GDM)和妊娠期糖耐量受损(GIGT)的患病率、相关危险因素及妊娠并发症。

设计

回顾性研究。

地点

社区教学医院。

参与者

回顾了2005 - 2007年1653名年龄≤19岁孕妇的结果。

干预措施

所有孕妇均采用50克葡萄糖耐量试验(GCT)进行筛查,GCT结果≥140毫克/分升的患者接受3小时100克口服葡萄糖耐量试验(OGTT)。

主要观察指标

GDM诊断为至少两项结果异常,GIGT诊断为一项结果异常。对GDM和GIGT病例评估任何相关危险因素的存在情况以及危险因素的存在对妊娠结局的影响。

结果

根据Carpenter和Coustan标准,GDM的患病率为0.85%(95%CI,0.41 - 1.29),GIGT为0.5%(95%CI,0.15 - 0.81),GDM + GIGT为1.35%(95%CI,0.78 - 1.88)。68%的患者至少有一项危险因素,包括体重指数≥25、糖尿病家族史和多囊卵巢综合征(PCOS)。其中只有9.1%(n = 2)的患者在孕期需要胰岛素来调节血糖,巨大儿发生率为9.1%(n = 2)。所有患者均为初产妇,剖宫产率为27.3%(n = 6)。我们未发现GDM和GIGT病例中危险因素的存在对妊娠结局有任何影响。

结论

我们证明GDM和GIGT与孕前高体重指数、PCOS及糖尿病家族史密切相关。由于GDM是一种糖尿病前期状态,考虑到青少年的预期寿命,在青少年妊娠中进行诊断以采取预防措施避免糖尿病很重要。

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