Jiwani Aliya, Marseille Elliot, Lohse Nicolai, Damm Peter, Hod Moshe, Kahn James G
Health Strategies International, San Francisco, USA.
J Matern Fetal Neonatal Med. 2012 Jun;25(6):600-10. doi: 10.3109/14767058.2011.587921. Epub 2011 Jul 15.
The association between gestational diabetes mellitus (GDM), perinatal complications and long-term morbidity is gaining increased attention. However, the global burden of GDM and the existing responses are not fully understood. We aimed to assess country prevalence and to summarize practices related to GDM screening and management.
Data on prevalence and country practices were obtained from a survey administered to diabetologists, obstetricians and others working on GDM in 173 countries.
GDM prevalence estimates range from <1% to 28%, with data derived from expert estimates, and single-site, multi-site and national prevalence assessments. Seventy-four percent of countries that completed the survey have national GDM guidelines or recommendations. Countries use a variety of screening approaches. In the countries where universal screening is recommended, the percentage of pregnant women screened ranges from 10% to >90%.
We found large variations in estimated GDM prevalence, but direct comparison between countries is difficult due to different diagnostic strategies and subpopulations. Many countries do not perform systematic screening for GDM, and practices often diverge from guidelines. Countries need to carefully assess the cost and health impact of scaling up GDM screening and management in order to identify the best policy option for their population.
妊娠期糖尿病（GDM）与围产期并发症及远期发病之间的关联日益受到关注。然而，GDM的全球负担以及现有的应对措施尚未得到充分了解。我们旨在评估各国的患病率，并总结与GDM筛查和管理相关的做法。
关于患病率和各国做法的数据来自对173个国家从事GDM工作的糖尿病专家、产科医生及其他人员进行的一项调查。
GDM患病率估计值范围从<1%至28%，数据来源于专家估计以及单中心、多中心和全国患病率评估。完成调查的国家中有74%拥有国家GDM指南或建议。各国采用多种筛查方法。在建议进行普遍筛查的国家中，接受筛查的孕妇比例从10%至>90%不等。
我们发现GDM患病率估计值差异很大，但由于诊断策略和亚人群不同，各国之间难以进行直接比较。许多国家未对GDM进行系统筛查，且做法往往与指南不一致。各国需要仔细评估扩大GDM筛查和管理的成本及对健康的影响，以便为其人群确定最佳政策选项。
