Division of Research, Kaiser Permanente of Northern California, Oakland, CA, USA.
Am J Obstet Gynecol. 2011 Mar;204(3):240.e1-6. doi: 10.1016/j.ajog.2010.10.907. Epub 2011 Jan 17.
We sought to estimate the risk of large for gestational age (LGA) across categories of glucose tolerance.
In a cohort of 89,141 participants, women without gestational diabetes mellitus (GDM) were categorized by their screening and diagnostic test results; those with GDM were categorized as meeting the National Diabetes Data Group or only the American Diabetes Association (ADA) criteria. Multivariable logistic regression models estimated the risk of LGA; screening values 5.5-6.0 mmol/L comprised the referent.
In women without GDM, the odds ratio for LGA was 1.89 (95% confidence interval [CI], 1.45-2.45) for fasting, 1.57 (95% CI, 1.31-1.89) for 1-hour, 1.60 (95% CI, 1.33-1.93) for 2-hour, and 1.62 (95% CI, 1.23-2.14) for 3-hour values meeting the ADA time point-specific thresholds.
For GDM identified in a 2-step procedure, our findings support the use of isolated abnormal fasting values according to the ADA threshold in identifying women who could benefit from treatment.
我们旨在评估不同葡萄糖耐量类别中巨大儿(LGA)的风险。
在 89141 名参与者的队列中,根据筛查和诊断测试结果对无妊娠糖尿病(GDM)的女性进行分类;将 GDM 患者分为符合国家糖尿病数据组或仅符合美国糖尿病协会(ADA)标准的患者。多变量逻辑回归模型估计了 LGA 的风险;筛查值 5.5-6.0mmol/L 为参考值。
在无 GDM 的女性中,空腹值、1 小时值、2 小时值和 3 小时值符合 ADA 时间点特定阈值时,LGA 的比值比分别为 1.89(95%置信区间[CI],1.45-2.45)、1.57(95%CI,1.31-1.89)、1.60(95%CI,1.33-1.93)和 1.62(95%CI,1.23-2.14)。
对于两步法确定的 GDM,我们的研究结果支持根据 ADA 阈值使用孤立的异常空腹值来识别可能受益于治疗的女性。