根据国际糖尿病与妊娠研究组标准，患有和不患有妊娠期糖尿病的女性的妊娠结局。
Pregnancy outcomes in women with and without gestational diabetes mellitus according to the International Association of the Diabetes and Pregnancy Study Groups criteria.
机构信息
Department of Obstetrics and Gynecology, University of Montreal, Montreal, Quebec, Canada.
出版信息
Obstet Gynecol. 2012 Oct;120(4):746-52. doi: 10.1097/AOG.0b013e31826994ec.
OBJECTIVE
To estimate the incidence of gestational diabetes mellitus (GDM) according to The International Association of the Diabetes and Pregnancy Study Groups (IADPSG) criteria and the pregnancy complications in women fulfilling these criteria but who are not considered diabetic according to the Canadian Diabetes Association criteria.
METHODS
We estimated the rate of GDM according to the IADPSG criteria from November 2008 to October 2010. Then, we conducted a chart review to compare maternal and neonatal outcomes between women classified as GDM according to the IADPSG criteria but not by the Canadian Diabetes Association criteria (group 1; n=186) and nondiabetic women according to both criteria (group 2; n=372). Results were expressed as crude (odds ratio [OR]) or adjusted OR and 95% confidence interval (CI). The study has a statistical power of 80% to detect a difference between 16% and 8% in large for gestational age newborns (α level of 0.05; two-tailed).
RESULTS
The rate of GDM using the IADPSG criteria was 27.51% (95% CI 25.92-29.11). Group 1 presented similar rates of large-for-gestational-age newborns (9.1% compared with 5.9%, adjusted OR 1.58, 95% CI 0.79-3.13; P=.19), delivery complications (37.1% compared with 30.1%, OR 1.37, 95% CI 0.95-1.98; P=.10), preeclampsia (6.5% compared with 2.7%, adjusted OR 2.40, 95% CI 0.92-6.27; P=.07), prematurity (6.5% compared with 2.7%, OR 1.10, 95% CI 0.53-2.27; P=.85), neonatal complications at delivery (13.4% compared with 9.7%, OR 1.45, 95% CI 0.84-2.49; P=.20), and metabolic complications (10.8% compared with 14.2%, OR 0.73, 95% CI 0.42-1.26; P=.29) compared with group 2.
CONCLUSION
Women classified as nondiabetic by the Canadian Diabetes Association Criteria but considered GDM according to the IADPSG criteria have similar pregnancy outcomes as women without GDM. More randomized studies with cost-effectiveness analyses are needed before implementation of these criteria.
LEVEL OF EVIDENCE
II.
目的
根据国际妊娠合并糖尿病研究组（IADPSG）标准估计妊娠糖尿病（GDM）的发病率，并评估符合这些标准但根据加拿大糖尿病协会标准不被认为是糖尿病的女性的妊娠并发症。
方法
我们根据 IADPSG 标准，从 2008 年 11 月至 2010 年 10 月估计 GDM 的发生率。然后，我们进行了图表回顾，比较了根据 IADPSG 标准但不符合加拿大糖尿病协会标准（第 1 组；n=186）和根据两个标准均无糖尿病的女性（第 2 组；n=372）的母婴结局。结果表示为粗（比值比[OR]）或调整后的 OR 和 95%置信区间（CI）。该研究的统计效能为 80%，可检测出巨大儿（出生体重大于相应胎龄第 90 百分位）的发生率在 16%和 8%之间的差异（α水平为 0.05；双侧）。
结果
使用 IADPSG 标准的 GDM 发生率为 27.51%（95%CI 25.92-29.11）。第 1 组巨大儿的发生率相似（9.1%比 5.9%，调整后的 OR 1.58，95%CI 0.79-3.13；P=0.19）、分娩并发症（37.1%比 30.1%，OR 1.37，95%CI 0.95-1.98；P=0.10）、子痫前期（6.5%比 2.7%，调整后的 OR 2.40，95%CI 0.92-6.27；P=0.07）、早产（6.5%比 2.7%，OR 1.10，95%CI 0.53-2.27；P=0.85）、分娩时新生儿并发症（13.4%比 9.7%，OR 1.45，95%CI 0.84-2.49；P=0.20）和代谢并发症（10.8%比 14.2%，OR 0.73，95%CI 0.42-1.26；P=0.29）与第 2 组相似。
结论
根据加拿大糖尿病协会标准被认为是非糖尿病患者，但根据 IADPSG 标准被认为是 GDM 的女性，其妊娠结局与无 GDM 的女性相似。在实施这些标准之前，需要进行更多具有成本效益分析的随机研究。
证据水平
II 级。
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