Siegel Anne M, Coxwell Carrie A, Biggio Joseph R, Tita Alan, Harper Lorie M
Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Center for Women's Reproductive Health, University of Alabama at Birmingham, Birmingham, Alabama.
Department of Family Medicine, University of Alabama at Tuscaloosa, Tuscaloosa, Alabama.
Am J Perinatol. 2017 May;34(6):557-562. doi: 10.1055/s-0036-1594016. Epub 2016 Nov 17.
Current standard of care in the United States uses a two-step screening and diagnosis approach for gestational diabetes mellitus (GDM). We aimed to assess the impact of the interval between screening and diagnosis on maternal and perinatal outcomes. This is a retrospective cohort study of singleton pregnancies complicated by GDM at a single tertiary center from 2007 to 2013. Women were divided into three groups based on the interval between their screening and diagnostic tests: ≤ 7, 8 to 14, and > 14 days. Maternal outcomes were mode of delivery, White class A2GDM, and preeclampsia. Perinatal outcomes included preterm birth, birth weight, macrosomia, hypoglycemia, and birth injury. Chart review revealed 1,212 women with diagnosis of GDM and 565 were included in the analysis with 310 (55%) women ≤ 7 days, 149 (26%) women within 8 to 14 days, and 106 (19%) women > 14 days group. All maternal and perinatal outcomes were similar between groups including risk of cesarean delivery, A2GDM, preeclampsia, macrosomia, preterm birth, hypoglycemia, and birth injury. Increasing time interval between screening and diagnosis may not negatively affect maternal or perinatal outcomes in pregnancies complicated by GDM.
美国目前的护理标准采用两步筛查和诊断方法来诊断妊娠期糖尿病(GDM)。我们旨在评估筛查与诊断之间的时间间隔对孕产妇和围产期结局的影响。 这是一项对2007年至2013年在单一三级中心发生的单胎妊娠合并GDM的回顾性队列研究。根据筛查和诊断测试之间的时间间隔,将女性分为三组:≤7天、8至14天和>14天。孕产妇结局包括分娩方式、白类A2GDM和先兆子痫。围产期结局包括早产、出生体重、巨大儿、低血糖和出生损伤。 病历审查发现1212名被诊断为GDM的女性,其中565名被纳入分析,≤7天组有310名(55%)女性,8至14天组有149名(26%)女性,>14天组有106名(19%)女性。各组之间所有孕产妇和围产期结局均相似,包括剖宫产风险、A2GDM、先兆子痫、巨大儿、早产、低血糖和出生损伤。 GDM合并妊娠中,筛查与诊断之间的时间间隔增加可能不会对孕产妇或围产期结局产生负面影响。