Department of Endocrinology and Metabolism, Istanbul, Turkey.
Department of Endocrinology and Metabolism, Acıbadem University Medical Faculty, Istanbul, Turkey.
Diabet Med. 2019 Feb;36(2):221-227. doi: 10.1111/dme.13857. Epub 2018 Nov 29.
Prevalence rates of gestational diabetes mellitus (GDM) show considerable variation among different countries and regions of the world. The primary aim of this study was to determine the nationwide prevalence and predictors of GDM in Turkey.
We conducted prospective nationwide screening among pregnant women. Between August 2016 and November 2017, a total of 2643 pregnant women from 51 centres in 12 different regions were enrolled. A two-step screening method and Carpenter and Coustan criteria were used in the diagnosis of GDM. Clinical and biochemical data were obtained using electronic database software.
The national prevalence of GDM was found to be 16.2% [95% confidence intervals (CI) 15.0% to 17.4%] without a significant difference between urban and rural regions. Women with GDM were older (mean age: 32 ± 5 vs. 28 ± 5 years, P < 0.001) and heavier (mean BMI: 27.2 ± 5.1 vs. 24.7 ± 4.7 kg/m , P < 0.001) than their counterparts without GDM. The prevalence of GDM tended to increase with age (< 25 years, 6.9%; 26-35 years, 15.6%; and 36-45 years, 32.7%; P < 0.001). Maternal age, maternal BMI, history of previous GDM and family history of diabetes mellitus were independent predictors of developing GDM (P < 0.05 for all). Low-risk women (age < 25 years, BMI < 25 kg/m , no family history of diabetes) comprised 10.7% of the total population and the prevalence of GDM in these women was 4.5% (95% CI 2.4% to 7.8%).
The results of this nationwide study indicate that GDM is very common, affecting one in seven pregnancies in Turkey. Implementation of international guidelines on screening and management of this public health problem is required.
妊娠糖尿病（GDM）的患病率在世界不同国家和地区存在较大差异。本研究的主要目的是确定土耳其全国 GDM 的患病率及其预测因素。
我们对孕妇进行了前瞻性全国性筛查。在 2016 年 8 月至 2017 年 11 月期间，共有来自 12 个不同地区的 51 个中心的 2643 名孕妇入组。采用两步筛查法和 Carpenter 和 Coustan 标准诊断 GDM。使用电子数据库软件获取临床和生化数据。
全国 GDM 的患病率为 16.2%（95%置信区间 15.0%至 17.4%），城乡之间无显著差异。患有 GDM 的女性年龄较大（平均年龄：32±5 岁 vs. 28±5 岁，P<0.001）且体重指数较高（平均 BMI：27.2±5.1 kg/m2 vs. 24.7±4.7 kg/m2，P<0.001）。GDM 的患病率随年龄增加而升高（<25 岁为 6.9%；26-35 岁为 15.6%；36-45 岁为 32.7%；P<0.001）。母亲年龄、母亲 BMI、既往 GDM 史和糖尿病家族史是发生 GDM 的独立预测因素（均 P<0.05）。低危妇女（年龄<25 岁，BMI<25 kg/m2，无糖尿病家族史）占总人口的 10.7%，这些妇女的 GDM 患病率为 4.5%（95%置信区间 2.4%至 7.8%）。
本项全国性研究结果表明，GDM 非常普遍，影响土耳其七分之一的妊娠。需要实施国际指南，以筛查和管理这一公共卫生问题。
