Gariani Karim, Egloff Michael, Prati Sarah, Philippe Jacques, Boulvain Michel, Jornayvaz François R
Division of Endocrinology, Diabetes, Hypertension and Nutrition, Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 4, Geneva, Switzerland.
Division of Obstetrics, Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 4, Geneva, Switzerland.
Exp Clin Endocrinol Diabetes. 2019 Jul;127(7):473-476. doi: 10.1055/a-0735-9469. Epub 2018 Sep 26.
To evaluate if the adoption of the International Association of Diabetes and Pregnancy Study Groups (IADPSG) diagnostic criteria for Gestational Diabetes Mellitus (GDM) led to changes in the management and in the occurrence of pregnancy complications.
This was a retrospective study of women with GDM followed at a single university center, diagnosed in 2009-2010 using the Carpenter and Coustan criteria (period 1) and in 2012-2013 using the IADPSG criteria (period 2).
We included 286 women with GDM, 129 in period 1 and 157 in period 2. Age, body mass index and weight gain during pregnancy were similar. There were less women requiring insulin therapy in period 2 than in period 1 (43.3% versus 55.0% respectively, p=0.048), but no significant difference in the number of cesarean section, in babies born large for gestational age and in the occurrence of preeclampsia. There was less neonatal hypoglycemia (<2.5 mmol/l) in period 2 versus period 1 (7 versus 23 neonates respectively, p<0.001).
When using the new IADPSG criteria, women with a less severe GDM are diagnosed, and fewer women require insulin. There was no difference in maternal outcomes, but less neonatal hypoglycemia during when using the IADPSG criteria.
评估采用国际糖尿病与妊娠研究组(IADPSG)的妊娠期糖尿病(GDM)诊断标准是否会导致管理方式及妊娠并发症发生率的改变。
这是一项针对在单一大学中心接受随访的GDM女性的回顾性研究,这些女性在2009 - 2010年采用卡彭特和库斯坦标准进行诊断(第1阶段),在2012 - 2013年采用IADPSG标准进行诊断(第2阶段)。
我们纳入了286例GDM女性,第1阶段129例,第2阶段157例。年龄、体重指数和孕期体重增加情况相似。第2阶段需要胰岛素治疗的女性比第1阶段少(分别为43.3%和55.0%,p = 0.048),但剖宫产数量、大于胎龄儿出生数量和先兆子痫发生率无显著差异。第2阶段新生儿低血糖(<2.5 mmol/l)情况比第1阶段少(分别为7例和23例新生儿,p<0.001)。
使用新的IADPSG标准时,诊断出的GDM病情较轻的女性更少,需要胰岛素治疗的女性也更少。孕产妇结局无差异,但使用IADPSG标准时新生儿低血糖情况较少。