Helseth Ragnhild, Salvesen Oyvind, Stafne Signe N, Mørkved Siv, Salvesen Kjell A, Carlsen Sven M
Department of Internal Medicine, Drammen Hospital , Vestre Viken.
Scand J Clin Lab Invest. 2014 Oct;74(7):620-8. doi: 10.3109/00365513.2014.928942. Epub 2014 Jul 1.
Gestational diabetes mellitus (GDM) is associated with both maternal and offspring adverse effects. The World Health Organization (WHO) has recently adopted novel GDM criteria. The aim of this study was to evaluate the former WHO and a simplified version of the new International Association for Diabetes in Pregnancy Study Group (IADPSG) criteria as to prevalence of and risk factors for GDM in a Nordic Caucasian population.
A 75 g oral glucose tolerance test was performed in 687 women at 18-22 and 32-36 pregnancy weeks. GDM was defined according to the WHO criteria as fasting plasma glucose ≥ 7.0 mmol/L and/or 2-hour plasma glucose ≥ 7.8 mmol/L and by a simplified version of the IADPSG criteria as either fasting glucose ≥ 5.1 mmol/L and/or 2-h plasma glucose ≥ 8.5 mmol/L. One-hour glucose values were not available and were thus not included in the diagnosis of GDM by IADPSG. Prevalence of GDM during pregnancy and risk factors for GDM at 18-22 weeks were studied in retrospect according to each of the two criteria.
The total prevalence of GDM during pregnancy was 6.1% (42/687) for the WHO criteria and 7.4% (51/687) for the simplified IADPSG criteria. High maternal age and short stature were independently associated with WHO GDM. Maternal age, fasting insulin and no regular exercise at 18-22 pregnancy weeks associated with simplified IADPSG GDM.
Simplified IADPSG criteria moderately increase GDM prevalence compared with the WHO criteria. Risk factors for GDM differ with the diagnostic criteria used.
妊娠期糖尿病（GDM）与母婴不良影响均相关。世界卫生组织（WHO）最近采用了新的GDM诊断标准。本研究的目的是评估既往WHO标准以及新的国际妊娠糖尿病研究组（IADPSG）标准的简化版，以了解北欧白种人群中GDM的患病率及危险因素。
对687名妊娠18 - 22周和32 - 36周的女性进行75克口服葡萄糖耐量试验。根据WHO标准，GDM定义为空腹血糖≥7.0 mmol/L和/或服糖后2小时血糖≥7.8 mmol/L；根据IADPSG标准的简化版，定义为空腹血糖≥5.1 mmol/L和/或服糖后2小时血糖≥8.5 mmol/L。无法获取1小时血糖值，因此IADPSG诊断GDM时未纳入该值。根据这两种标准，回顾性研究妊娠期GDM的患病率以及妊娠18 - 22周时GDM的危险因素。
根据WHO标准，妊娠期GDM的总患病率为6.1%（42/687）；根据IADPSG标准的简化版，总患病率为7.4%（51/687）。高龄产妇和身材矮小与WHO标准诊断的GDM独立相关。妊娠18 - 22周时的产妇年龄、空腹胰岛素水平以及缺乏规律运动与IADPSG标准简化版诊断的GDM相关。
与WHO标准相比，IADPSG标准的简化版适度提高了GDM的患病率。GDM的危险因素因所使用的诊断标准而异。
