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世界卫生组织妊娠期糖尿病新诊断标准的实施对患病率及围产期结局的影响:一项基于人群的研究

Impact of the Implementation of New WHO Diagnostic Criteria for Gestational Diabetes Mellitus on Prevalence and Perinatal Outcomes: A Population-Based Study.

作者信息

Erjavec Katja, Poljičanin Tamara, Matijević Ratko

机构信息

Department of Obstetrics and Gynecology, University Hospital Merkur, Zajčeva 19, 10 000 Zagreb, Croatia.

Department of Medical Informatics and Biostatistics, Croatian Institute of Public Health, Rockefellerova 7, 10 000 Zagreb, Croatia.

出版信息

J Pregnancy. 2016;2016:2670912. doi: 10.1155/2016/2670912. Epub 2016 Dec 21.

Abstract

. To determine the impact of the implementation of new WHO diagnostic criteria for gestational diabetes mellitus (GDM) on prevalence, predictors, and perinatal outcomes in Croatian population. . A cross-sectional study was performed using data from medical birth certificates collected in 2010 and 2014. Data collected include age, height, and weight before and at the end of pregnancy, while perinatal outcome was assessed by onset of labor, mode of delivery, and Apgar score. . A total of 81.748 deliveries and 83.198 newborns were analysed. Prevalence of GDM increased from 2.2% in 2010 to 4.7% in 2014. GDM was a significant predictor of low Apgar score (OR 1.656), labor induction (OR 2.068), and caesarean section (OR 1.567) in 2010, while in 2014 GD was predictive for labor induction (OR 1.715) and caesarean section (OR 1.458) only. Age was predictive for labor induction only in 2014 and for caesarean section in both years, while BMI before pregnancy was predictive for all observed perinatal outcomes in both years. . Despite implementation of new guidelines, GDM remains burdened with increased risk of labor induction and caesarean section, but no longer with low Apgar score, while BMI remains an important predictor for all three perinatal outcomes.

摘要

确定世界卫生组织(WHO)新的妊娠期糖尿病(GDM)诊断标准的实施对克罗地亚人群中该疾病的患病率、预测因素及围产期结局的影响。

采用2010年和2014年收集的医学出生证明数据进行了一项横断面研究。收集的数据包括年龄、孕前及孕末期的身高和体重,围产期结局通过分娩发动情况、分娩方式及阿氏评分进行评估。

共分析了81748例分娩及83198例新生儿。GDM的患病率从2010年的2.2%升至2014年的4.7%。2010年,GDM是低阿氏评分(比值比[OR] 1.656)、引产(OR 2.068)及剖宫产(OR 1.567)的显著预测因素,而在2014年,GDM仅为引产(OR 1.715)和剖宫产(OR 1.458)的预测因素。年龄仅在2014年是引产的预测因素,在这两年都是剖宫产的预测因素,而孕前体重指数(BMI)在这两年都是所有观察到的围产期结局的预测因素。

尽管实施了新指南,但GDM仍存在引产和剖宫产风险增加的问题,但不再与低阿氏评分相关,而BMI仍然是所有三种围产期结局的重要预测因素。

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