From Quest Diagnostics, West Norriton, Pennsylvania, San Juan Capistrano, California, and Madison, New Jersey.
Obstet Gynecol. 2011 Jan;117(1):61-68. doi: 10.1097/AOG.0b013e3181fe424b.
To estimate the screening rate and prevalence of gestational diabetes mellitus (GDM) and the screening rate and prevalence of postpartum diabetes, in a large, national sample of pregnant women. We also estimated the potential effects of the new International Association of Diabetes and Pregnancy Study Groups recommendations, which replace the 100-g oral glucose tolerance test (OGTT) with the 75-g OGTT, on GDM prevalence and gestational plasma glucose testing practices.
We identified pregnant women who used the laboratory services of Quest Diagnostics and who were screened for GDM and were tested postpartum. Gestational diabetes mellitus prevalence was calculated according to the current American Diabetes Association/ Carpenter-Coustan criteria, and the new International Association of Diabetes and Pregnancy Study Groups criteria.
Sixty-eight percent (632,820/924,873) of pregnant women aged 25 to 40 (ie, those not in a low-risk age group) who utilized the services of Quest Diagnostics during this study were screened for GDM. Of the entire adult pregnant population (ages 18-40) who received GDM screening, 5% (40,955/842,993) had positive test results under the current criteria. Nineteen percent (4,486/23,299) of those with GDM received postpartum diabetes testing within a 6-month period. Ninety percent (148,749/166,085) of all confirmatory GDM tests performed on pregnant women at Quest Diagnostics were the 100-g OGTT. The number of women with GDM after receiving the 75-g OGTT would have doubled under the International Association of Diabetes and Pregnancy Study Groups criteria.
Many women may not be receiving GDM screening during pregnancy. Postpartum diabetes screening rates after pregnancy remain low. Adoption of the new International Association of Diabetes and Pregnancy Study Groups criteria would require a significant change in current clinical practice.
III.
在一个大型的全国性孕妇样本中，估计妊娠期糖尿病（GDM）的筛查率和患病率，以及产后糖尿病的筛查率和患病率。我们还估计了新的国际妊娠糖尿病研究组建议的潜在影响，该建议用 75 克口服葡萄糖耐量试验（OGTT）取代 100 克 OGTT，对 GDM 的患病率和妊娠期间血糖检测实践的影响。
我们确定了使用 Quest Diagnostics 实验室服务并接受 GDM 筛查和产后检测的孕妇。根据当前的美国糖尿病协会/卡朋特-库斯坦标准和新的国际妊娠糖尿病研究组标准计算 GDM 的患病率。
在这项研究中，68%（632820/924873）年龄在 25 至 40 岁（即不属于低风险年龄组）的接受 Quest Diagnostics 服务的孕妇接受了 GDM 的筛查。在接受 GDM 筛查的整个成年孕妇（年龄 18-40 岁）人群中，5%（40955/842993）根据现行标准检测结果呈阳性。19%（4486/23299）的 GDM 患者在 6 个月内接受了产后糖尿病检测。在 Quest Diagnostics 对孕妇进行的所有确诊 GDM 检测中，90%（148749/166085）为 100 克 OGTT。根据国际妊娠糖尿病研究组的标准，接受 75 克 OGTT 的 GDM 患者人数将增加一倍。
许多孕妇在怀孕期间可能未接受 GDM 筛查。产后糖尿病筛查率仍较低。采用新的国际妊娠糖尿病研究组标准将需要对当前的临床实践进行重大改变。
III。
