Benhalima Katrien, Mathieu Chantal, Van Assche André, Damm Peter, Devlieger Roland, Mahmood Tahir, Dunne Fidelma
Department of Endocrinology, UZ Gasthuisberg, KU Leuven, Belgium.
Department of Endocrinology, UZ Gasthuisberg, KU Leuven, Belgium.
Eur J Obstet Gynecol Reprod Biol. 2016 Jun;201:197-202. doi: 10.1016/j.ejogrb.2016.04.003. Epub 2016 Apr 11.
More uniformity is necessary in screening and diagnosis for gestational diabetes (GDM) across Europe. The European Board and College of Obstetrics and Gynaecology (EBCOG) has recently recommended to use the 2013 World Health Organization (WHO) criteria for the diagnosis of GDM. We evaluated the uptake of these EBCOG recommendations in guidelines for GDM screening across Europe.
Between September and November 2015, an online survey on the current national or regional recommendations for GDM screening was directed to the 33 European countries that are members of EBCOG.
There was a response rate of 84.8% (28 countries). From Belgium, data were separately obtained from the Dutch-and the French-speaking parts and from the UK data were also obtained from Scotland, leading to data from 30 responders. The response rates were high in Central Europe (100%), Northern Europe (100%) and Southern Europe (85.7%) with lower response rates in Eastern Europe (71.4%). 82.1% of guidelines recommend screening for unknown diabetes at first prenatal visit and 67.9% recommend to screen for GDM before 24 weeks of pregnancy. All guidelines recommend to screen for GDM ≥24 weeks, based on risk factors in 64.3% and by universal screening in 35.7%. The most commonly used diagnostic criteria for GDM are the 2013 WHO criteria in 67.9%, the 1999 WHO criteria in 10.7%, the European Association for the Study of Diabetes criteria in 7.1% and the Carpenter & Coustan criteria in 7.1%. Of all societies advising the use of the 2013 WHO criteria, 52.6% recommends this based on risk factors, 10.5% recommends universal screening in a two-step strategy and 36.8% recommends a universal one-step approach with a 75g OGTT.
Our survey shows that the majority of European societies now advise to use the 2013 WHO criteria for GDM. However, only 36.8% recommends a universal one-step approach with a 75g OGTT with the majority of societies recommending screening based on risk factors. The use of common diagnostic criteria for GDM by the majority of societies is an important first step towards achieving uniformity in GDM screening across Europe.
欧洲各地妊娠期糖尿病（GDM）的筛查和诊断需要更高的一致性。欧洲妇产科委员会（EBCOG）最近建议采用2013年世界卫生组织（WHO）的GDM诊断标准。我们评估了欧洲各地GDM筛查指南对这些EBCOG建议的采纳情况。
2015年9月至11月期间，针对EBCOG的33个欧洲成员国开展了一项关于当前国家或地区GDM筛查建议的在线调查。
回复率为84.8%（28个国家）。从比利时分别获取了荷兰语区和法语区的数据，从英国也获取了苏格兰的数据，从而得到了30个回复者的数据。中欧（100%）、北欧（100%）和南欧（85.7%）的回复率较高，东欧（71.4%）的回复率较低。82.1%的指南建议在首次产前检查时筛查未确诊的糖尿病，67.9%建议在妊娠24周前筛查GDM。所有指南均建议在妊娠≥24周时筛查GDM，其中64.3%基于危险因素进行筛查，35.7%采用普遍筛查。GDM最常用的诊断标准是2013年WHO标准（67.9%）、1999年WHO标准（10.7%）、欧洲糖尿病研究协会标准（7.1%）和Carpenter & Coustan标准（7.1%）。在所有建议采用2013年WHO标准的协会中，52.6%基于危险因素推荐该标准，10.5%推荐在两步法策略中进行普遍筛查，36.8%推荐采用75g口服葡萄糖耐量试验（OGTT）的普遍一步法。
我们的调查显示，大多数欧洲协会现在建议采用2013年WHO标准诊断GDM。然而，只有36.8%推荐采用75g OGTT的普遍一步法，大多数协会推荐基于危险因素进行筛查。大多数协会采用共同的GDM诊断标准是在欧洲实现GDM筛查一致性的重要第一步。
