Everett W D
Department of Family Practice, Ehrling Bergquist USAF Regional Hospital, Omaha, Nebraska.
Am J Prev Med. 1989 Jan-Feb;5(1):38-43.
The current recommendation to screen all pregnant mothers for diabetes at 28 weeks of gestation is examined using known epidemiological evidence in a cost-benefit analysis. The available data indicate that the potential decrease in the perinatal mortality rate would be the most cost-efficient potential health outcome of a gestational diabetes screening policy. A decrease in macrosomia and cesarean sections would be additional potential benefits, but at a cost so great that it is not an important factor in making a decision to screen for gestational diabetes. Since it is unlikely that a study can be done that would ethically demonstrate the effectiveness of universal screening in decreasing the perinatal mortality rate, further research should perhaps focus on decreasing the cost of screening, as the available data do not clearly demonstrate a favorable cost-benefit ratio in universal screening for gestational diabetes.
利用已知的流行病学证据，通过成本效益分析对目前在妊娠28周时对所有孕妇进行糖尿病筛查的建议进行了研究。现有数据表明，围产期死亡率的潜在降低将是妊娠糖尿病筛查政策最具成本效益的潜在健康成果。巨大儿和剖宫产率的降低将是额外的潜在益处，但成本过高，以至于在决定是否进行妊娠糖尿病筛查时并非重要因素。由于不太可能进行一项从伦理角度证明普遍筛查在降低围产期死亡率方面有效性的研究，进一步的研究或许应侧重于降低筛查成本，因为现有数据并未明确表明妊娠糖尿病普遍筛查具有良好的成本效益比。
