Bassaw Bharat, Fletcher Horace, Rattray Carole, McIntyre Garth, Sarkharkar Vrunda, Sankat Sarisha, Sirjusingh Adesh, Chinnia Javed
a Department of Obstetrics and Gynaecology, The University of the West Indies , Trinidad and Tobago.
b Department of Obstetrics and Gynaecology, The University of the West Indies , Jamaica.
J Obstet Gynaecol. 2018 Nov;38(8):1035-1038. doi: 10.1080/01443615.2018.1467389. Epub 2018 Sep 26.
Gestational diabetes mellitus (GDM) is defined as a glucose intolerance first recognised in pregnancy. The World Health Organization (WHO) in 2015 revised the definition into either diabetes in pregnancy (DIP) which includes pre-existing diabetes (type 1 or type 2) that antedates pregnancy or diabetes diagnosed during pregnancy with the WHO diagnostic criteria for diabetes mellitus (DM) in the non-pregnant state, and GDM for milder forms of hyperglycaemia in pregnancy. The main purpose of the screening and diagnosis of GDM is to identify pregnancies in which the foetus is at a high risk of an adverse perinatal outcome, and the mother and the offspring are of serious long-term sequelae. This review of the literature provides an overview of associated prevalence, risk factors and diagnosis of GDM. It also addresses the benefits of screening with supportive evidence. Based on this review, we recommend especially in low-resourced countries such as the Caribbean, adoption of a universal screening with the two-step method.
妊娠期糖尿病(GDM)被定义为首次在妊娠期间被识别出的葡萄糖不耐受。世界卫生组织(WHO)在2015年将定义修订为妊娠糖尿病(DIP),其中包括妊娠前就已存在的糖尿病(1型或2型)或根据WHO非妊娠状态下糖尿病(DM)诊断标准在妊娠期间诊断出的糖尿病,以及妊娠期间较轻形式高血糖的GDM。GDM筛查和诊断的主要目的是识别胎儿围产期不良结局风险高、母亲和后代有严重长期后遗症的妊娠。本文献综述概述了GDM的相关患病率、危险因素和诊断。它还阐述了筛查的益处并提供了支持证据。基于此综述,我们特别建议在加勒比等资源匮乏的国家采用两步法进行普遍筛查。