2012-2016 年美国活产分娩妇女中既往糖尿病和妊娠期糖尿病的流行情况及变化。
Prevalence and Changes in Preexisting Diabetes and Gestational Diabetes Among Women Who Had a Live Birth - United States, 2012-2016.
出版信息
MMWR Morb Mortal Wkly Rep. 2018 Nov 2;67(43):1201-1207. doi: 10.15585/mmwr.mm6743a2.
Diabetes during pregnancy increases the risk for adverse maternal and infant health outcomes. Type 1 or type 2 diabetes diagnosed before pregnancy (preexisting diabetes) increases infants' risk for congenital anomalies, stillbirth, and being large for gestational age (1). Diabetes that develops and is diagnosed during the second half of pregnancy (gestational diabetes) increases infants' risk for being large for gestational age (1) and might increase the risk for childhood obesity (2); for mothers, gestational diabetes increases the risk for future type 2 diabetes (3). In the United States, prevalence of both preexisting and gestational diabetes increased from 2000 to 2010 (4,5). Recent state-specific trends have not been reported; therefore, CDC analyzed 2012-2016 National Vital Statistics System (NVSS) birth data. In 2016, the crude national prevalence of preexisting diabetes among women with live births was 0.9%, and prevalence of gestational diabetes was 6.0%. Among 40 jurisdictions with continuously available data from 2012 through 2016, the age- and race/ethnicity-standardized prevalence of preexisting diabetes was stable at 0.8% and increased slightly from 5.2% to 5.6% for gestational diabetes. Preconception care and lifestyle interventions before, during, and after pregnancy might provide opportunities to control, prevent, or mitigate health risks associated with diabetes during pregnancy.
妊娠期间的糖尿病会增加母婴健康不良结局的风险。妊娠前诊断的 1 型或 2 型糖尿病(原有糖尿病)会增加婴儿先天畸形、死产和巨大儿的风险(1)。在妊娠后半期出现并诊断的糖尿病(妊娠期糖尿病)会增加婴儿巨大儿的风险(1),并可能增加儿童肥胖的风险(2);对于母亲来说,妊娠期糖尿病会增加未来患 2 型糖尿病的风险(3)。在美国,原有和妊娠期糖尿病的患病率从 2000 年到 2010 年都有所增加(4,5)。最近还没有报告各州的具体趋势;因此,CDC 分析了 2012-2016 年国家生命统计系统(NVSS)的出生数据。2016 年,活产妇女中原有糖尿病的粗全国患病率为 0.9%,妊娠期糖尿病的患病率为 6.0%。在 2012 年至 2016 年期间连续提供数据的 40 个管辖区中,原有糖尿病的年龄和种族/族裔标准化患病率稳定在 0.8%,而妊娠期糖尿病的患病率从 5.2%略有上升至 5.6%。在妊娠前、妊娠期间和妊娠后进行孕前保健和生活方式干预可能为控制、预防或减轻与妊娠期间糖尿病相关的健康风险提供机会。