Sugiyama Mindy S, Cash Haley L, Roseveare Christine, Reklai Rumi, Basilius Kliu, Madraisau Sherilynn
Bureau of Public Health, Ministry of Health, Koror, Palau.
Pacific Island Health Officers Association, Honolulu, HI, USA.
Matern Child Health J. 2017 Oct;21(10):1961-1966. doi: 10.1007/s10995-017-2313-0.
Objective Gestational diabetes mellitus (GDM) in Palau and across the Pacific Islands is a serious public health issue that is currently understudied. Methods This study was a retrospective cohort study that included 1730 women with a single live birth in Palau between January 2007 and December 2014. Results The overall prevalence of GDM among women in Palau was 5.5%. Women who were older (≥30 years) or obese (BMI ≥30) were more likely to have GDM than women who were younger (<30 years) or non-obese (BMI <30), respectively. When adverse birth outcomes were assessed, women with GDM were found to have significantly higher prevalence of high birth weight infants, cesarean sections, and neonatal deaths when compared to women without GDM. In fact, women with GDM were five times more likely to have a neonatal death than women without GDM (p = 0.008). Conclusion Reducing overall rates of obesity in the population could help reduce rates of diabetes and GDM in Palau. Based on this work, current practices for the identification, monitoring and treatment of women with GDM should be evaluated and strengthened in order to reduce neonatal mortality rates in Palau.
目的 帕劳及整个太平洋岛屿地区的妊娠期糖尿病（GDM）是一个严重的公共卫生问题，目前研究不足。方法 本研究为回顾性队列研究，纳入了2007年1月至2014年12月期间在帕劳单胎活产的1730名妇女。结果 帕劳女性中GDM的总体患病率为5.5%。年龄较大（≥30岁）或肥胖（BMI≥30）的女性比年龄较小（<30岁）或非肥胖（BMI<30）的女性更易患GDM。在评估不良分娩结局时，发现患有GDM的女性与未患GDM的女性相比，高出生体重婴儿、剖宫产和新生儿死亡的患病率显著更高。事实上，患有GDM的女性发生新生儿死亡的可能性是未患GDM女性的五倍（p = 0.008）。结论 降低人群总体肥胖率有助于降低帕劳的糖尿病和GDM发病率。基于此项研究，应评估并加强目前对GDM女性的识别、监测和治疗措施，以降低帕劳的新生儿死亡率。
