The International Diabetes Federation, Brussels, Belgium.
The International Diabetes Federation, Brussels, Belgium.
Diabetes Res Clin Pract. 2014 Feb;103(2):176-85. doi: 10.1016/j.diabres.2013.11.003. Epub 2013 Dec 1.
We estimated the number of live births worldwide and by IDF Region who developed hyperglycaemia in pregnancy in 2013, including total diabetes in pregnancy (known and previously undiagnosed diabetes) and gestational diabetes.
Studies reporting prevalence of hyperglycaemia first-detected in pregnancy (formerly termed gestational diabetes) were identified using PubMed and through a review of cited literature. A simple scoring system was developed to characterise studies on diagnostic criteria, year study was conducted, study design, and representation. The highest scoring studies by country with sufficient detail on methodology for characterisation and reporting at least three age-groups were selected for inclusion. Forty-seven studies from 34 countries were used to calculate age-specific prevalence of hyperglycaemia first-detected in pregnancy in women 20-49 years. Adjustments were then made to account for heterogeneity in screening method and blood glucose diagnostic threshold in studies and also to align with recently published diagnostic criteria as defined by the WHO for hyperglycaemia first detected in pregnancy. Prevalence rates were applied to fertility and population estimates to determine regional and global prevalence of hyperglycaemia in pregnancy for 2013. An estimate of the proportion of cases of hyperglycaemia in pregnancy due to total diabetes in pregnancy was calculated using age- and sex-specific estimates of diabetes from the IDF Diabetes Atlas and applied to age-specific fertility rates.
The global prevalence of hyperglycaemia in pregnancy in women (20-49 years) is 16.9%, or 21.4 million live births in 2013. An estimated 16.0% of those cases may be due to total diabetes in pregnancy. The highest prevalence was found in the South-East Asia Region at 25.0% compared with 10.4% in the North America and Caribbean Region. More than 90% of cases of hyperglycaemia in pregnancy are estimated to occur in low- and middle-income countries.
These are the first global estimates of hyperglycaemia in pregnancy and conform to the new WHO recommendations regarding diagnosis and also include estimates of live births in women with known diabetes. They indicate the importance of the disease from a public health and maternal and child health perspective, particularly in developing countries.
我们估算了 2013 年全世界及 IDF 区域活产婴儿数量，以及在妊娠期间发展为高血糖的人数，包括妊娠糖尿病（已知和以前未诊断的糖尿病）和妊娠期糖尿病。
使用 PubMed 检索和查阅参考文献，确定报道首次在妊娠期间发现的高血糖患病率（以前称为妊娠期糖尿病）的研究。我们开发了一个简单的评分系统来描述研究的诊断标准、研究年份、研究设计和代表性。根据国家的得分高低，选择得分最高且具有足够详细的方法学特征描述和报告至少 3 个年龄组的研究纳入分析。从 34 个国家的 47 项研究中，计算了 20-49 岁妇女妊娠期间首次发现的高血糖的年龄特异性患病率。根据筛查方法和血糖诊断阈值的异质性以及与世界卫生组织最近发布的妊娠期间首次发现的高血糖的诊断标准进行调整。根据生育率和人口估计，计算了 2013 年妊娠期间高血糖的区域和全球患病率。使用 IDF 糖尿病图谱中糖尿病的年龄和性别特异性估计值，计算了妊娠期间高血糖归因于妊娠糖尿病的病例比例，并应用于年龄特异性生育率。
全球 20-49 岁妇女妊娠期间高血糖的患病率为 16.9%，即 2013 年 2140 万活产婴儿。估计其中 16.0%的病例可能是由于妊娠糖尿病。东南亚地区的患病率最高，为 25.0%，而北美和加勒比地区为 10.4%。估计妊娠期间高血糖的 90%以上病例发生在中低收入国家。
这些是首次对妊娠期间高血糖的全球估计，符合世界卫生组织关于诊断的新建议，也包括已知患有糖尿病的妇女的活产婴儿估计数。这些估计值从公共卫生和母婴健康的角度表明了该疾病的重要性，特别是在发展中国家。
