Macaulay Shelley, Dunger David B, Norris Shane A
Medical Research Council/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, University of the Witwatersrand, Johannesburg, South Africa.
Medical Research Council/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, University of the Witwatersrand, Johannesburg, South Africa; Department of Paediatrics, University of Cambridge, Cambridge, United Kingdom.
PLoS One. 2014 Jun 3;9(6):e97871. doi: 10.1371/journal.pone.0097871. eCollection 2014.
Gestational diabetes mellitus (GDM) is any degree of impaired glucose tolerance first recognised during pregnancy. Most women with GDM revert to normal glucose metabolism after delivery of their babies; however, they are at risk of developing type 2 diabetes later in life as are their offspring. Determining a country's GDM prevalence can assist with policy guidelines regarding GDM screening and management, and can highlight areas requiring research. This systematic review assesses GDM prevalence in Africa.
Three electronic databases were searched without language restrictions; PubMed, Scopus and the Cochrane Library. Thirty-one search terms were searched. Eligible articles defined GDM, stated what GDM screening approaches were employed and reported GDM prevalence. The reporting quality and risk of bias within each study was assessed. The PRISMA guidelines for systematic reviews were followed. The literature search identified 466 unique records. Sixty full text articles were reviewed of which 14 were included in the systematic review. One abstract, for which the full text article could not be obtained, was also included. Information regarding GDM classification, screening methods and prevalence was obtained for six African countries; Ethiopia (n = 1), Morocco (n = 1), Mozambique (n = 1), Nigeria (n = 6), South Africa (n= 4) and Tanzania (n = 1). Prevalence figures ranged from 0% (Tanzania) to 13.9% (Nigeria) with some studies focussing on women with GDM risk factors. Most studies utilised the two hour 75 g oral glucose tolerance test and applied the World Health Organization's diagnostic criteria.
Six countries, equating to 11% of the African continent, were represented in this systematic review. This indicates how little is known about GDM in Africa and highlights the need for further research. Considering the increasing public health burden of obesity and type 2 diabetes, it is essential that the extent of GDM is understood in Africa to allow for effective intervention programmes.
妊娠期糖尿病（GDM）是指在孕期首次被识别出的任何程度的糖耐量受损。大多数患有GDM的女性在分娩后血糖代谢恢复正常；然而，她们以及其后代在日后患2型糖尿病的风险较高。确定一个国家的GDM患病率有助于制定有关GDM筛查和管理的政策指南，并能突出需要开展研究的领域。本系统评价评估了非洲的GDM患病率。
对三个电子数据库进行了无语言限制的检索；PubMed、Scopus和Cochrane图书馆。共检索了31个检索词。符合条件的文章对GDM进行了定义，说明了采用了哪些GDM筛查方法，并报告了GDM患病率。评估了每项研究的报告质量和偏倚风险。遵循了系统评价的PRISMA指南。文献检索共识别出466条独特记录。对60篇全文文章进行了审阅，其中14篇纳入了系统评价。还纳入了一篇无法获取全文文章的摘要。获取了六个非洲国家有关GDM分类、筛查方法和患病率的信息；埃塞俄比亚（n = 1）、摩洛哥（n = 1）、莫桑比克（n = 1）、尼日利亚（n = 6）、南非（n = 4）和坦桑尼亚（n = 1）。患病率从0%（坦桑尼亚）到13.9%（尼日利亚）不等，一些研究聚焦于具有GDM风险因素的女性。大多数研究采用了两小时75克口服葡萄糖耐量试验并应用了世界卫生组织的诊断标准。
本系统评价涵盖了六个国家，占非洲大陆的11%。这表明对非洲GDM的了解非常有限，并突出了进一步开展研究的必要性。考虑到肥胖症和2型糖尿病日益加重的公共卫生负担，了解非洲GDM的程度对于制定有效的干预计划至关重要。
