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妊娠糖尿病国际糖尿病妊娠研究组标准与旧版美国糖尿病协会诊断标准的比较。

Comparison of the International Association of Diabetes in Pregnancy Study Group Criteria with the Old American Diabetes Association Criteria for Diagnosis of Gestational Diabetes Mellitus.

作者信息

Niroomand Mahtab, Afsar Jamileh, Hosseinpanah Farhad, Afrakhteh Maryam, Farzaneh Farah, Serahati Sara

机构信息

Endocrinology Division, Department of Internal Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Department of Internal Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

出版信息

Int J Endocrinol Metab. 2019 Oct 6;17(4):e88343. doi: 10.5812/ijem.88343. eCollection 2019 Oct.

Abstract

OBJECTIVES

This study aimed to assess the prevalence of gestational diabetes mellitus (GDM) based on two sets of criteria, namely the old criteria suggested in 2009 by the American Diabetes Association and new criteria of the International Association of Diabetes in Pregnancy Study Group. We also evaluated the predictive power of the risk factors of GDM.

METHODS

Pregnant women from three outpatient clinics in Tehran, Iran, participated in this cross-sectional observational study. During the first perinatal visit, demographic data, medical histories, weight, and height of mothers were recorded. The mother's fasting glucose and glycosylated hemoglobin were measured. An oral glucose tolerance test was also performed. The prevalence of GDM, based on the two criteria, was estimated and its predictive factors were investigated.

RESULTS

Of 1,117 pregnant women, 156 (15.6%) and 71 (7.1%) patients had GDM based on the new and old criteria, respectively. Multivariate analysis showed that older age at pregnancy (OR = 1.05; 95% CI: 1.006 - 1.107; P = 0.03), higher body mass index (OR = 1.2; 95% CI: 1.15 - 1.3; P < 0.001), family history of diabetes (OR = 1.97; 95% CI: 1.11 - 3.5; P = 0.02), and history of macrosomia (OR = 7.8; 95% CI: 1.96 - 30.9; P = 0.004) were independent predictive factors for GDM.

CONCLUSIONS

Using the new criteria, the prevalence of GDM increases by 2.2 folds compared to the old criteria. Several factors can independently predict the occurrence of GDM.

摘要

目的

本研究旨在基于两套标准评估妊娠期糖尿病(GDM)的患病率,这两套标准分别是美国糖尿病协会2009年建议的旧标准以及国际妊娠糖尿病研究组的新标准。我们还评估了GDM危险因素的预测能力。

方法

来自伊朗德黑兰三家门诊诊所的孕妇参与了这项横断面观察性研究。在首次围产期检查时,记录母亲的人口统计学数据、病史、体重和身高。测量母亲的空腹血糖和糖化血红蛋白。还进行了口服葡萄糖耐量试验。基于这两套标准估计GDM的患病率,并调查其预测因素。

结果

在1117名孕妇中,分别有156名(15.6%)和71名(7.1%)患者根据新标准和旧标准被诊断为GDM。多变量分析显示,妊娠年龄较大(OR = 1.05;95% CI:1.006 - 1.107;P = 0.03)、体重指数较高(OR = 1.2;95% CI:1.15 - 1.3;P < 0.001)、糖尿病家族史(OR = 1.97;95% CI:1.11 - 3.5;P = 0.02)和巨大儿病史(OR = 7.8;95% CI:1.96 - 30.9;P = 0.004)是GDM的独立预测因素。

结论

与旧标准相比,使用新标准时GDM的患病率增加了2.2倍。有几个因素可以独立预测GDM的发生。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f8e7/6935709/4467b43bc76c/ijem-17-4-88343-i001.jpg

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